Xu et al reported a model for predicting the risk of readmission for an inpatient with decompensated cirrhosis. This can help to identify a patient who may require more aggressive management. The authors are from the Chngqing Medical University and the Fifth People's Hospital of Chengdu in China.
Patient selection: hospitalized adult with decompensated cirrhosis
Outcome: 90-day readmission
Parameters:
(1) serum sodium in mmol/L, from 110 to 150
(2) serum total bilirubin in µmol/L, from 0 to 600
(3) INR, from 0.5 to 5.0
(4) gastrointestinal bleeding
points for serum sodium =
= 301.5 - (2.01 * (sodium))
points for serum total bilirubin =
= (0.1667 * (bilirubin))
points for INR =
= (14.776 * (INR)) - 7.378
|
Parameter
|
Finding
|
Points
|
|
GI bleeding
|
no
|
0
|
|
|
yes
|
44.9
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 291.7
value of X =
= (0.0001336 * ((score)^2)) + (0.01637 * (score)) - 1.625
probability of readmission =
= 1 / (1 +EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.73 in the derivation cohort.
