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利用电子健康记录数据比较衰弱风险评分与合并症指数对医院再入院的影响

Comparison of a Frailty Risk Score and Comorbidity Indices for Hospital Readmission Using Electronic Health Record Data.

作者信息

Lekan Deborah A, McCoy Thomas P, Jenkins Marjorie, Mohanty Somya, Manda Prashanti, Yasin Reham

出版信息

Res Gerontol Nurs. 2021 Mar-Apr;14(2):91-103. doi: 10.3928/19404921-20210115-03. Epub 2021 Jan 25.

Abstract

The purpose of the current study was to investigate the predictive properties of five definitions of a frailty risk score (FRS) and three comorbidity indices using data from electronic health records (EHRs) of hospitalized adults aged ≥50 years for 3-day, 7-day, and 30-day readmission, and to identify an optimal model for a FRS and comorbidity combination. Retrospective analysis of the EHR dataset was performed, and multivariable logistic regression and area under the curve (AUC) were used to examine readmission for frailty and comorbidity. The sample ( = 55,778) was mostly female (53%), non-Hispanic White (73%), married (53%), and on Medicare (55%). Mean FRSs ranged from 1.3 ( = 1.5) to 4.3 ( = 2.1). FRS and comorbidity were independently associated with readmission. Predictive accuracy for FRS and comorbidity combinations ranged from AUC of 0.75 to 0.77 (30-day readmission) to 0.84 to 0.85 (3-day readmission). FRS and comorbidity combinations performed similarly well, whereas comorbidity was always independently associated with readmission. FRS measures were more associated with 30-day readmission than 7-day and 3-day readmission. [(2), 91-103.].

摘要

本研究的目的是利用年龄≥50岁住院成年人的电子健康记录(EHR)数据,调查虚弱风险评分(FRS)的五种定义和三种合并症指数对3天、7天和30天再入院情况的预测特性,并确定FRS与合并症组合的最佳模型。对EHR数据集进行了回顾性分析,并使用多变量逻辑回归和曲线下面积(AUC)来检查虚弱和合并症的再入院情况。样本(n = 55,778)大多为女性(53%)、非西班牙裔白人(73%)、已婚(53%)且参加医疗保险(55%)。平均FRS范围为1.3(标准差 = 1.5)至4.3(标准差 = 2.1)。FRS和合并症与再入院独立相关。FRS与合并症组合的预测准确性范围为30天再入院的AUC为0.75至0.77,3天再入院的AUC为0.84至0.85。FRS与合并症组合表现相似,而合并症始终与再入院独立相关。FRS测量与30天再入院的相关性高于7天和3天再入院。[(2),91 - 103。]

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