Who will be sicker in the morning? Changes in the Simple Clinical Score the day after admission and the subsequent outcomes of acutely ill unselected medical patients.

Hdl Handle:
http://hdl.handle.net/10147/205031
Title:
Who will be sicker in the morning? Changes in the Simple Clinical Score the day after admission and the subsequent outcomes of acutely ill unselected medical patients.
Authors:
Kellett, John; Emmanuel, Andrew; Deane, Breda
Affiliation:
Department of Medicine, Nenagh Hospital, Nenagh, County Tipperary, Ireland. jgkellett@eircom.net
Citation:
Who will be sicker in the morning? Changes in the Simple Clinical Score the day after admission and the subsequent outcomes of acutely ill unselected medical patients. 2011, 22 (4):375-81 Eur. J. Intern. Med.
Journal:
European journal of internal medicine
Issue Date:
Aug-2011
URI:
http://hdl.handle.net/10147/205031
DOI:
10.1016/j.ejim.2011.03.005
PubMed ID:
21767755
Additional Links:
http://www.sciencedirect.com/science/article/pii/S0953620511000616
Abstract:
All doctors are haunted by the possibility that a patient they reassured yesterday will return seriously ill tomorrow. We examined changes in the Simple Clinical Score (SCS) the day after admission, factors that might influence these changes and the relationship of these changes to subsequent clinical outcome.; The SCS was recorded in 1165 patients on admission and again the following day (i.e. 25.0±15.8 h later). The abilities of 51 variables that might predict changes in the SCS were examined.; The day after admission 16.1% of patients had been discharged home, 31.4% had decreased their SCS by 2.4±1.6 points, 38.6% had an unchanged SCS, 12.0% had increased their SCS by 2.1±1.7 points and 1.2% had died. Patients with an increased SCS had higher in-hospital mortality (10% vs. 1.1%, OR 10.1, p<.001) and a longer length of stay (9.4±9.6 vs. 5.6±7.0 days, p<.001). There was no consistent association between the SCS recorded at admission and SCS increase. Only nursing home residence, heart failure and a Medical Admission Risk System laboratory data score>0.09 were found to be independent predictors of SCS increase.; The SCS of 12% of patients increases the day after admission to hospital, which is associated with a ten-fold increase of in-hospital mortality. Low SCS risk patients are just as likely to have a SCS increase as high risk patients.
Item Type:
Article
Language:
en
MeSH:
Acute Disease; Aged; Aged, 80 and over; Disease Progression; Female; Follow-Up Studies; Hospital Mortality; Humans; Ireland; Male; Middle Aged; Patient Admission; Prognosis; Prospective Studies; Risk Factors; Severity of Illness Index; Time Factors
ISSN:
1879-0828

Full metadata record

DC FieldValue Language
dc.contributor.authorKellett, Johnen
dc.contributor.authorEmmanuel, Andrewen
dc.contributor.authorDeane, Bredaen
dc.date.accessioned2012-01-26T11:22:45Z-
dc.date.available2012-01-26T11:22:45Z-
dc.date.issued2011-08-
dc.identifier.citationWho will be sicker in the morning? Changes in the Simple Clinical Score the day after admission and the subsequent outcomes of acutely ill unselected medical patients. 2011, 22 (4):375-81 Eur. J. Intern. Med.en
dc.identifier.issn1879-0828-
dc.identifier.pmid21767755-
dc.identifier.doi10.1016/j.ejim.2011.03.005-
dc.identifier.urihttp://hdl.handle.net/10147/205031-
dc.description.abstractAll doctors are haunted by the possibility that a patient they reassured yesterday will return seriously ill tomorrow. We examined changes in the Simple Clinical Score (SCS) the day after admission, factors that might influence these changes and the relationship of these changes to subsequent clinical outcome.-
dc.description.abstractThe SCS was recorded in 1165 patients on admission and again the following day (i.e. 25.0±15.8 h later). The abilities of 51 variables that might predict changes in the SCS were examined.-
dc.description.abstractThe day after admission 16.1% of patients had been discharged home, 31.4% had decreased their SCS by 2.4±1.6 points, 38.6% had an unchanged SCS, 12.0% had increased their SCS by 2.1±1.7 points and 1.2% had died. Patients with an increased SCS had higher in-hospital mortality (10% vs. 1.1%, OR 10.1, p<.001) and a longer length of stay (9.4±9.6 vs. 5.6±7.0 days, p<.001). There was no consistent association between the SCS recorded at admission and SCS increase. Only nursing home residence, heart failure and a Medical Admission Risk System laboratory data score>0.09 were found to be independent predictors of SCS increase.-
dc.description.abstractThe SCS of 12% of patients increases the day after admission to hospital, which is associated with a ten-fold increase of in-hospital mortality. Low SCS risk patients are just as likely to have a SCS increase as high risk patients.-
dc.language.isoenen
dc.relation.urlhttp://www.sciencedirect.com/science/article/pii/S0953620511000616en
dc.subject.meshAcute Disease-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshDisease Progression-
dc.subject.meshFemale-
dc.subject.meshFollow-Up Studies-
dc.subject.meshHospital Mortality-
dc.subject.meshHumans-
dc.subject.meshIreland-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPatient Admission-
dc.subject.meshPrognosis-
dc.subject.meshProspective Studies-
dc.subject.meshRisk Factors-
dc.subject.meshSeverity of Illness Index-
dc.subject.meshTime Factors-
dc.titleWho will be sicker in the morning? Changes in the Simple Clinical Score the day after admission and the subsequent outcomes of acutely ill unselected medical patients.en
dc.typeArticleen
dc.contributor.departmentDepartment of Medicine, Nenagh Hospital, Nenagh, County Tipperary, Ireland. jgkellett@eircom.neten
dc.identifier.journalEuropean journal of internal medicineen
dc.description.provinceMunster-
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