Limited Prognostic Utility of a Simplified Vital Sign Based Risk Calculator in Acute Medical Admissions
Conway, R.; Byrne, D.; O'Riordan, D.; Silke, B.
Acute Medicine 19(3): 138-144
2020
ISSN/ISBN: 1747-4892 PMID: 33020757 Document Number: 18208
Accurate efficient prognostication in acute medical admissions remains challenging. We constructed a Vital Sign based Risk Calculator using vital parameters and Major Disease Categories to predict 30-day in-hospital mortality using a multivariable fractional polynomial model. We evaluated 113,807 admissions in 58,126 patients. The Vital Sign based Risk Calculator predicted 30-day inhospital mortality to increase from 2 points - 3.6% (95%CI 3.4, 3.7) to 12 points - 14.8% (95%CI 14.0, 15.7). AUROC was 0.74 (95%CI 0.72, 0.74). The addition of illness severity and comorbidity data improved AUROC to 0.90 (95%CI 0.89, 0.90). The Vital Sign based Risk Calculator is limited by its simplicity; inclusion of illness severity and comorbidity data improve prediction.
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