predictive tool

Elevated level of urea is a good predictor for 30-day all-cause mortality in acutely admitted medical patients

Original Articles, Volume 20, Issue 3, Pages 157-248 (2021)

Objective: To assess the correlation between urea and mortality in acutely ill medical patients admitted to hospital.
Methods: We included consecutively admitted adult patients from the medical admission unit at a regional Danish hospital. Data on mortality was extracted. The association with 30-day mortality was described using cubic splines, and discriminatory power, crude association and adjusted analyses were performed.
Results: We included 5,894 patients, with a 30-day mortality of 5.6%. We found a dose-response relation between urea and 30-day mortality with an increase from 2.7% to 19.5% (p<0.001). Conclusion: Elevated urea is strongly associated with 30-day all-cause mortality in acutely admitted medical patients with acceptable discrimination and good calibration.

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Can we predict Acute Medical readmissions using the BOOST tool? A retrospective case note review

Research Audit and Clinical Practice, Volume 15, Issue 3, Pages 109 – 164 (2016)

Abstract

Background: Readmissions within 30-days of hospital discharge are a problem. The aim was to determine if the Better Outcomes for Older Adults through Safe Transitions (BOOST) risk assessment tool was applicable within the UK.

Methods: Patients over 65 readmitted were identified retrospectively via a casenote review. BOOST assessment was applied with 1 point for each risk factor.

Results: 324 patients were readmitted (mean age 77 years) with a median of 7 days between discharge and readmission. The median BOOST score was 3 (IQR 2-4) with polypharmacy evident in 88% and prior hospitalisation in 70%. The tool correctly predicted 90% of readmissions using two or more risk factors and 99.1% if one risk factor was included.

Conclusion: The BOOST assessment tool appears appropriate in predicting readmissions however further analysis is required to determine its precision.

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