Abstract
Purpose: The Intermediate Care Unit Severity Score (IMCUSS) is an easy to calculate predictor of in-hospital death, and the only such tool developed for patients in the intermediate care setting. We sought to examine its external validity. Materials and methods: Using data from patients admitted to the intermediate care unit (IMCU) of an urban academic medical center from July to December of 2012, model discrimination and calibration for predicting in-hospital death were assessed using the area under the receiver operating characteristic (AUROC) and the Hosmer-Lemeshow goodness-of-fit chi-squared (HL GOF X2) test, respectively. The standardized mortality ratio (SMR) with 95% confidence intervals (95% CI) was also calculated. Results: The cohort included data from 628 unique admissions to the IMCU. Overall hospital mortality was 8.3%. The median IMCUSS was 10 (Interquartile Range: 0–16), with 229 (36%) patients having a score of zero. The AUROC for the IMCUSS was 0.72 (95% CI: 0.64–0.78), the HL GOF X2 = 30.7 (P < 0.001), and the SMR was 1.22 (95% CI: 0.91–1.60). Conclusions: The IMCUSS exhibited acceptable discrimination, poor calibration, and underestimated mortality. Other centers should assess the performance of the IMCUSS before adopting its use.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 94-98 |
| Number of pages | 5 |
| Journal | Journal of Critical Care |
| Volume | 46 |
| DOIs | |
| State | Published - Aug 1 2018 |
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Keywords
- Intermediate care
- Mortality prediction
- Outcome prediction score
- Progressive care
- Stepdown care
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
Cite this
Hospital mortality prediction for intermediate care patients : Assessing the generalizability of the Intermediate Care Unit Severity Score (IMCUSS). / Hager, David Northrop; Tanykonda, Varshitha; Noorain, Zeba; Sahetya, Sarina; Simpson, Catherine E.; Lucena, Juan Felipe; Needham, Dale.
In: Journal of Critical Care, Vol. 46, 01.08.2018, p. 94-98.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hospital mortality prediction for intermediate care patients
T2 - Assessing the generalizability of the Intermediate Care Unit Severity Score (IMCUSS)
AU - Hager, David Northrop
AU - Tanykonda, Varshitha
AU - Noorain, Zeba
AU - Sahetya, Sarina
AU - Simpson, Catherine E.
AU - Lucena, Juan Felipe
AU - Needham, Dale
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Purpose: The Intermediate Care Unit Severity Score (IMCUSS) is an easy to calculate predictor of in-hospital death, and the only such tool developed for patients in the intermediate care setting. We sought to examine its external validity. Materials and methods: Using data from patients admitted to the intermediate care unit (IMCU) of an urban academic medical center from July to December of 2012, model discrimination and calibration for predicting in-hospital death were assessed using the area under the receiver operating characteristic (AUROC) and the Hosmer-Lemeshow goodness-of-fit chi-squared (HL GOF X2) test, respectively. The standardized mortality ratio (SMR) with 95% confidence intervals (95% CI) was also calculated. Results: The cohort included data from 628 unique admissions to the IMCU. Overall hospital mortality was 8.3%. The median IMCUSS was 10 (Interquartile Range: 0–16), with 229 (36%) patients having a score of zero. The AUROC for the IMCUSS was 0.72 (95% CI: 0.64–0.78), the HL GOF X2 = 30.7 (P < 0.001), and the SMR was 1.22 (95% CI: 0.91–1.60). Conclusions: The IMCUSS exhibited acceptable discrimination, poor calibration, and underestimated mortality. Other centers should assess the performance of the IMCUSS before adopting its use.
AB - Purpose: The Intermediate Care Unit Severity Score (IMCUSS) is an easy to calculate predictor of in-hospital death, and the only such tool developed for patients in the intermediate care setting. We sought to examine its external validity. Materials and methods: Using data from patients admitted to the intermediate care unit (IMCU) of an urban academic medical center from July to December of 2012, model discrimination and calibration for predicting in-hospital death were assessed using the area under the receiver operating characteristic (AUROC) and the Hosmer-Lemeshow goodness-of-fit chi-squared (HL GOF X2) test, respectively. The standardized mortality ratio (SMR) with 95% confidence intervals (95% CI) was also calculated. Results: The cohort included data from 628 unique admissions to the IMCU. Overall hospital mortality was 8.3%. The median IMCUSS was 10 (Interquartile Range: 0–16), with 229 (36%) patients having a score of zero. The AUROC for the IMCUSS was 0.72 (95% CI: 0.64–0.78), the HL GOF X2 = 30.7 (P < 0.001), and the SMR was 1.22 (95% CI: 0.91–1.60). Conclusions: The IMCUSS exhibited acceptable discrimination, poor calibration, and underestimated mortality. Other centers should assess the performance of the IMCUSS before adopting its use.
KW - Intermediate care
KW - Mortality prediction
KW - Outcome prediction score
KW - Progressive care
KW - Stepdown care
UR - http://www.scopus.com/inward/record.url?scp=85047434489&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85047434489&partnerID=8YFLogxK
U2 - 10.1016/j.jcrc.2018.05.009
DO - 10.1016/j.jcrc.2018.05.009
M3 - Article
C2 - 29804039
AN - SCOPUS:85047434489
VL - 46
SP - 94
EP - 98
JO - Journal of Critical Care
JF - Journal of Critical Care
SN - 0883-9441
ER -