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Table 1 COHORT characteristics and unadjusted outcomesa

From: Prospective evaluation of social risks, physical function, and cognitive function in prediction of non-elective rehospitalization and post-discharge mortality

 

All other hospitalizations

Excluded or not selected

Interviewed and enrolled

P

Number of patientsb

31,275

2,548

1,551

–-

Age (Median, mean ± SD)

67.0, 64.4 ± 18.1

72.0, 69.6 ± 16.9

67.0, 65.2 ± 15.1

0.0333

Sex (% male)

48.9

48.5

46.5

0.0588

Race (%)

  White

52.6

55.8

54.7

0.0968

  Black/African American

15.8

16.6

21.0

 < .0001

  Hispanic

14.0

11.4

9.1

 < .0001

  Asian

14.9

13.9

12.4

0.0044

  Other/unknown race

2.6

2.4

2.7

0.8563

Charlson Comorbidity Index scorec (Median, mean ± SD)

2.0, 2.7 ± 2.8

3.0, 4.0 ± 3.2

3.0, 3.4 ± 3.0

 < .0001

COPS2 (Median, mean ± SD)

21.0, 36.6 ± 38.3

45.0, 61.4 ± 56.0

31.0, 49.9 ± 47.2

 < .0001

LAPS2 (Median, mean ± SD)

45.0, 53.1 ± 38.9

68.0, 70.2 ± 42.3

57.0, 59.5 ± 38.0

 < .0001

Admitted for observation (%)

26.1

6.8

0.5

 < .0001

Full code on admission (%)

89.8

80.5

92.3

0.0003

Ever admitted to ICU (%)

12.5

18.2

14.9

0.0103

Discharge diagnosesd (%)

  Sepsis

12.1

18.8

19.5

 < .0001

  Community-acquired pneumonia

1.4

1.7

1.1

0.2546

  Acute myocardial infarction

3.1

2.7

3.4

0.5818

  Congestive heart fail

0.5

0.9

0.6

0.7275

  Gastrointestinal bleeding

1.3

1.0

1.4

0.8527

  All other

81.6

74.9

74.1

 < .0001

Length of stay (days (Median, mean ± SD)

2.0, 3.4 ± 5.0

3.5, 5.9 ± 8.7

3.7, 5.0 ± 5.0

 < .0001

Full code on discharge (%)

86.1

73.7

90.3

 < .0001

TSL scoree (Median, mean ± SD)

9.0, 11.4 ± 7.9

12.0, 16.2 ± 11.7

9.0, 12.8 ± 9.5

 < .0001

Died during initial hospitalization (%)

2.2

2.3

0.3

 < .0001

Non-elective hospitalization within 30 days of discharge (%)

8.3

14.5

13.0

 < .0001

Died within 30 days of discharge (%)

2.6

6.6

2.1

0.1878

Died or had non-elective hospitalization within 30 days of discharge (%)

10.3

19.6

13.6

0.0002

  1. aTable 1 provides information on interviewed patients, patients who were excluded or not selected, and all remaining patients (except 712 patients who refused and whose data could not be used). See text, Figure 1, and Appendix 2 for additional details regarding the recruitment process. SD = standard deviation ICU = intensive care unit. The P value shown compares interviewed and enrolled patients to all other hospitalizations; additional comparisons are provided in Appendix 4
  2. bDuring the study period, a total of 36,086 adult patients were hospitalized in Oakland, San Leandro, and Walnut Creek hospitals. Of these, 1,551 patients agreed to be interviewed, 4 of whom died prior to discharge resulting in 1547 patients in the final analysis cohort; 712 patients refused to participate, and we could not use their data; lastly, 2,548 patients were excluded or not selected. For comparison purposes, we selected the first hospitalization experienced by patients who had multiple hospitalizations during the study period (N = 31,275, far left column)
  3. cThe Charlson Comorbidity Index score (range, 0–40; higher scores indicate greater comorbidity burden) was calculated using the methodology of Deyo et al. [27]. COPS2 = COmorbidity Point Score, version 2 (COPS2, range, 0 to 1010, higher scores indicate increasing comorbidity burden) is assigned based on all diagnoses incurred by a patient in the 12 months preceding the index hospitalization. The univariate relationship of COPS2 with 30-day mortality is as follows: 0–39, 1.7%; 40–64, 5.2%; 65 + , 9.0%. LAPS2 = Laboratory-based Acute Physiology Score, version 2 (LAPS2, range, 0 to 414, higher scores indicating increasing physiologic derangement) is assigned based on a patient’s worst vital signs, pulse oximetry, neurological status, and 16 laboratory test results in the preceding 24 (hourly and discharge LAPS2) or 72 h (admission LAPS2). The univariate relationship of an admission LAPS2 with 30-day mortality is as follows: 0–59, 1.0%; 60–109, 5.0%; 110 + , 13.7%. See Escobar et al. [23]
  4. dSee text and Escobar et al. [23] for description of how we grouped diagnosis codes into Primary Conditions
  5. eTSL = Transition Support Level score. This score is assigned at 6 AM on the day of discharge to all adult hospitalized patients in Kaiser Permanente Northern California. The score, which is expressed as a percent, is calibrated against a composite outcome (non-elective hospitalization and/or death within 30 days of discharge). It is based on a patient’s LAPS2, COPS2, length of stay, recent hospital and emergency department utilization preceding the current hospitalization, and discharge care directive (full code or not); see Escobar et al. [17] for details. Patients with a TSL score of ≥ 25% receive additional assessments and follow-up calls and appointments
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BMC Health Services Research

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