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Prognostic Tool ID's Risk of Death for Hospital Patients

Prognostic Tool ID's Risk of Death for Hospital Patients

Upon admission, CARING criteria estimate risk of death in one year for hospitalized patients

TUESDAY, Dec. 17, 2013 (HealthDay News) -- A validation study has confirmed that the CARING criteria may be used upon admission to estimate the risk of death at one year for inpatients in broad hospital settings, according to research published in the December issue of the Journal of Hospital Medicine.

Jeanie Youngwerth, M.D., of the University of Colorado in Aurora, and colleagues performed a retrospective observational cohort study to validate the CARING criteria (developed and tested in a Veteran's Administration [VA] hospital setting) in university and safety-net hospital settings.

The researchers found that the CARING criteria predicted higher one-year mortality among inpatients, including C (primary diagnosis of cancer; odds ratio [OR], 7.23), I (intensive care unit admission with multiple organ failure; OR, 6.97), and NG (meeting two or more non-cancer hospice guidelines; OR, 15.55). One-year survival was significantly lower among patients who met one or more of the CARING criteria (including A for two or more admissions to the hospital for a chronic illness within the past year and R for resident in a nursing home). Increasing age also added to increased risk of one-year mortality.

"This study validated the CARING criteria in a tertiary referral university hospital and safety-net hospital setting, demonstrating applicability in a much broader population than the VA hospital of the original CARING criteria study," the authors write.

Abstract (http://onlinelibrary.wiley.com/doi/10.1002/jhm.2107/abstract )Full Text (subscription or payment may be required) (http://onlinelibrary.wiley.com/doi/10.1002/jhm.2107/full )