Mobility Identifies Acutely Ill Patients at Low Risk of In-Hospital Mortality

Nickel, Christian H.; Kellett, John; Ortega, Ricardo Nieves; Lyngholm, Le; Wasingya-Kasereka, Lucien; Brabrand, Mikkel

doi:10.1016/j.chest.2019.04.001

Cited by 13 publications

(19 citation statements)

References 19 publications

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“…37,38 In comparison, vital sign normality and IMOP are simple and practical pragmatic ways to quickly assess physiologic reserve in acute settings. 39…”

Section: Discussionmentioning

confidence: 99%

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A simple prognostic score predicts one‐year mortality of alert and calm emergency department patients: A prospective two‐center observational study

et al. 2020

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Study Objective To derive and validate a prognostic score to predict 1‐year mortality using vital signs, mobility and other variables that are readily available at the bedside at no additional cost. Methods Post hoc analysis of two independent prospective observational studies in two emergency departments, one in Denmark and the other in Switzerland. Participants Alert and calm emergency department patients. Measurements The prediction of mortality from presentation to 365 days by vital signs, mobility and other variables that are readily available at the bedside at no additional cost. Results One thousand six hundred and eighteen alert and calm patients were in the Danish cohort and 1331 in the Swiss cohort. Logistic regression identified age >68 years, abnormal vital signs, impaired mobility and the decision to admit as significant predictors of 365‐day mortality. A simple prognostic score awarded one point to each of these predictors. Less than two of these predictors were present in 45.6% of patients, and only 0.4% of these patients died within a year. If two or more of these predictors were present, 365‐day mortality increased exponentially. Conclusion Age >68 years, the decision for hospital admission, any vital sign abnormality at presentation and impaired mobility at presentation are equally powerful predictors of 1‐year mortality in alert and calm emergency department patients. If validated by others these predictors could be used to discharge patients with confidence since nearly half of these patients had less than two predictors and none of them died within 30 days. However, when two or more predictors were present 365‐day mortality increased exponentially.

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“…37,38 In comparison, vital sign normality and IMOP are simple and practical pragmatic ways to quickly assess physiologic reserve in acute settings. 39…”

Section: Discussionmentioning

confidence: 99%

“…Physiological reserve reduces progressively with age and frailty, the definition and identification of which is not universally agreed . In comparison, vital sign normality and IMOP are simple and practical pragmatic ways to quickly assess physiologic reserve in acute settings …”

Section: Discussionmentioning

confidence: 99%

A simple prognostic score predicts one‐year mortality of alert and calm emergency department patients: A prospective two‐center observational study

et al. 2020

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“…Efficiency includes cost consumption index and time consumption index, which respectively indicate the cost of the same disease and the length of hospital stay [10]. The medical safety index uses low-risk mortality to reflect the probability of death in DRG group with low mortality in the whole province [11].…”

Section: Methodsmentioning

confidence: 99%

Analysis of the Effect of DRG Medical Insurance Payment on the Performance of Hospital Service in Hunan Province

Wang

Peng

et al. 2021

Preprint

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Background: Performance evaluation is an important means to promote the hospital's medical ability and management ability. Therefore, the aim of this study was to explore the effect of DRG payment mode on the performance of inpatient services in large tertiary hospitals. Methods: Based on the relevant report data of DRG pilot hospital and control hospital from 2015 to 2020, CN-DRG was used as grouping method, and case mix index (CMI), DRG group number, cost consumption index, time consumption index, low-risk group mortality and other indicators were used to analyze the impact of DRG on hospital inpatient service performance from the aspects of medical service ability, medical service efficiency, medical safety. Results: The average annual growth rate of DRG group was 4.07%, the average annual growth rate of CMI was 0.95%, the time consumption index and cost consumption index were lower than 1, and the mortality rate of low-risk group decreased by 27.56%. Conclusions: DRG medical insurance payment can improve the performance of inpatient service in the process of hospital management.

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“…Combination of vital signs with warning scores, for example in combination with biomarkers, could help to identify low-risk patients [66]. Other -non-traditional -"vital signs" such as mental status [67][68][69], mobility [70,71] [72] and frailty [73] have been advocated.…”

Section: Advances Due To Symptom-oriented Research At Triagementioning

confidence: 99%

The last decade of symptom-oriented research in emergency medicine: triage, work-up, and disposition

Bingisser

Nickel

2019

Swiss Med Wkly

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As a result of the ever-increasing use of imaging and clinical chemistry, symptom-oriented research has lost ground in many areas of clinical medicine. In emergency medicine, the importance of symptom-oriented research is obvious, as the three major tasks (triage, work-up and disposition) are still under-investigated. Scientific progress is closely linked to the analysis of readily available information, such as the patients' symptoms.A decade ago, there were more questions than answers. Therefore, we describe the state of the evidence and the importance of symptoms for decisions at triage, during work-up and for disposition. Recent advances in each field focusing on symptoms as predictors of outcome and/or diagnosis are shown. Finally, future directions of research regarding novel triage tools, efficient work-up and evidence-based disposition are discussed. Symptom-oriented research has been a driver for medical progress for centuries, and re-focusing on patient-centred clinical research will strengthen this field in the future in order to support smarter medicine.

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Mobility Identifies Acutely Ill Patients at Low Risk of In-Hospital Mortality

Cited by 13 publications

References 19 publications

A simple prognostic score predicts one‐year mortality of alert and calm emergency department patients: A prospective two‐center observational study

A simple prognostic score predicts one‐year mortality of alert and calm emergency department patients: A prospective two‐center observational study

Analysis of the Effect of DRG Medical Insurance Payment on the Performance of Hospital Service in Hunan Province

The last decade of symptom-oriented research in emergency medicine: triage, work-up, and disposition

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