Daniel Baram¹, Feroza Daroowalla¹, Ruel Garcia¹, Guangxiang Zhang², John J. Chen², Erin Healy³, Syed Ali Riaz⁴ and Paul Richman¹

¹Division of Pulmonary/Critical Care Medicine, ²Department of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, NY 11794, ³Center for Public Health and Health Policy Research, Stony Brook University Medical Center, ⁴Department of Medicine, Methodist Hospital, Brooklyn NY.

Abstract

Objective: To evaluate the performance of APR-DRG (All Patient Refined—Diagnosis Related Group) Risk of Mortality (ROM) score as a mortality risk adjustor in the intensive care unit (ICU).

Design: Retrospective analysis of hospital mortality.

Setting: Medical ICU in a university hospital located in metropolitan New York.

Patients: 1213 patients admitted between February 2004 and March 2006.

Main results: Mortality rate correlated significantly with increasing APR-DRG ROM scores (p  0.0001). Multiple logistic regression analysis demonstrated that, after adjusting for patient age and disease group, APR-DRG ROM was significantly associated with mortality risk in patients, with a one unit increase in APR-DRG ROM associated with a 3-fold increase in mortality.

Conclusions: APR-DRG ROM correlates closely with ICU mortality. Already available for many hospitalized patients around the world, it may provide a readily available means for severity-adjustment when physiologic scoring is not available.