Emergency admissions’ diagnoses and risk of in-hospital death according to the primary ICD-10 chapter assigned at discharge and the National Early Warning Score on admission

Q3 Medicine

Acute Medicine Pub Date : 2023-07-01 DOI:10.52964/amja.0945

Mark Holland, Alexander Dannatt, John Kellett, Darren Green

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Abstract

Background: The relationship between diagnosis, illness severity, and mortality risk for unselected emergency admissions is poorly defined. Aim: To define primary ICD-10 diagnostic chapters at discharge, admission illness severity by the National Early Warning Score, and in-hospital mortality for all unselected emergency admissions. Method: Retrospective, observational, cohort study of 122,259 unselected, adult emergency admissions to Salford Royal Hospital between 2014 and 2022. Results: In-hospital mortality was 4.3% but most patients had an ICD-10 chapter associated with a lower risk of death. 60% of in-hospital deaths were in four chapters, infections, circulatory and respiratory diseases, or neoplasms. An admission NEWS ≥3 was associated with earlier mortality and an eight-fold increased risk of in-hospital mortality. 45% of all in-hospital deaths occurred in patients with an admission NEWS <3. Conclusion: Mortality in emergency hospital admissions is associated with illness severity and four diagnostic chapters. NEWS should not be the only arbiter of hospital admission, as for certain diagnostic chapters the risk of death is high even if vital signs on presentation are normal.

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根据出院时指定的ICD-10初级章节和入院时的国家早期预警评分，急诊入院的诊断和院内死亡风险

背景:未选择急诊入院的诊断、疾病严重程度和死亡风险之间的关系定义不清。目的:定义ICD-10在出院时的主要诊断章节，通过国家早期预警评分确定入院时的疾病严重程度，以及所有未选择急诊入院的住院死亡率。方法:回顾性、观察性、队列研究，对2014年至2022年索尔福德皇家医院122,259名未经选择的成人急诊患者进行研究。结果:住院死亡率为4.3%，但大多数患者的ICD-10章节与较低的死亡风险相关。60%的院内死亡发生在四种疾病:感染、循环系统和呼吸系统疾病或肿瘤。入院时NEWS≥3与早期死亡率相关，住院死亡率风险增加8倍。45%的院内死亡发生在住院患者中。结论:急诊住院死亡率与疾病严重程度和四个诊断章节有关。新闻不应该是入院的唯一仲裁者，因为对于某些诊断章节，即使出现时的生命体征正常，死亡的风险也很高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acute Medicine Medicine-Emergency Medicine

CiteScore

1.50

自引率

0.00%

发文量

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