Can Waterlow score predict 30-day mortality and length of stay in acutely admitted medical patients (aged ≥65 years)? Evidence from a single centre prospective cohort study.
BMJ Open
; 9(11): e032347, 2019 11 14.
Article
en En
| MEDLINE
| ID: mdl-31727661
ABSTRACT
OBJECTIVE:
This study aimed to explore the potential for the Waterlow score (WS) to be used as a predictor of 30-day mortality and length of hospital stay (LHS) in acutely admitted medical patients aged 65 years and older.DESIGN:
Prospective observational cohort study.SETTING:
UK District General Hospital.SUBJECTS:
834 consecutive patients aged 65 years and older admitted acutely to medical specialties between 30 May and 22 July 2014.METHODS:
Admission WS (range 4-64) assessment paired with the patient's status at 30 days in terms of mortality and their LHS. PRIMARYOUTCOMES:
30-day mortality and length of inpatient stay.RESULTS:
834 consecutive acute medical admissions had their WS recorded. 30-day mortality was 13.1% (109 deaths). A significant difference in the distribution of WS (p<0.001) was seen between those who survived (median 12) and those who died (median 16) within 30 days, particularly within respiratory (p<0.001), stroke (p<0.001), cardiology (p<0.016), non-respiratory infections (p<0.018) and trauma (p<0.044) subgroups. Odds of dying within 30 days increased threefold for every 10-unit increase in the WS (p<0.001, 95% CI 2.1 to 4.3). LHS was also positively linearly associated with the WS in those who survived 30 days (median=5, IQR=10; r=0.32, p<0.01). A five-unit increase in WS was associated with approximately 5 days increase in LHS. On the other hand, quadratic regression showed this relationship was curvilinear and negative (concave) for those who died within 30 days where a five-unit increase in WS was associated with an approximately 10 days decrease in LHS.CONCLUSION:
This study demonstrates an association between a high WS and both 30-day mortality and LHS. This is particularly significant for mortality in patients in the respiratory, stroke and cardiac subcategories. The WS, a nursing-led screening tool that is carried out on virtually all admissions to UK hospitals, could have additional use at the time of patient admission as a risk assessment tool for 30-day mortality as well as a predictor of LHS.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Índice de Severidad de la Enfermedad
/
Mortalidad Hospitalaria
/
Tiempo de Internación
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País como asunto:
Europa
Idioma:
En
Año:
2019
Tipo del documento:
Article