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Use of the All Patient Refined-Diagnosis Related Group (APR-DRG) Risk of Mortality Score as a Severity Adjustor in the Medical ICU

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Publication Date: 18 Apr 2008

Journal: Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine Clinical Medicine: Circulatory, Respiratory and Pulmonary Medicine 2008:2 19-25

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Abstract 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.


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