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dc.contributor.authorKellett, John
dc.contributor.authorEmmanuel, Andrew
dc.contributor.authorDeane, Breda
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
html.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.
html.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.
html.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.
html.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.


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