Patient selection: coronary artery bypass graft surgery
Outcome: 90-day readmission
Parameters:
(1) length of stay in days
(2) insurance
(3) discharge destination
(4) congestive heart failure
(5) renal failure
(6) peripheral vascular disease
(7) liver disease
(8) in-hospital infection
(9) sex
|
Parameter
|
Finding
|
Points
|
|
length of stay
|
< 5 days
|
0
|
|
|
5 to 9 days
|
3
|
|
|
>= 10 days
|
10
|
|
insurance
|
private
|
0
|
|
|
Medicaid
|
7
|
|
|
Medicare
|
3
|
|
|
other
|
1
|
|
discharge destination
|
home
|
0
|
|
|
skilled nursing
|
5
|
|
congestive heart failure
|
absent
|
0
|
|
|
present
|
4
|
|
renal failure
|
absent
|
0
|
|
|
present
|
4
|
|
peripheral vascular disease
|
absent
|
0
|
|
|
present
|
4
|
|
liver disease
|
absent
|
0
|
|
|
present
|
4
|
|
in-hospital infection
|
absent
|
0
|
|
|
present
|
4
|
|
sex
|
male
|
0
|
|
|
female
|
3
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 45 (paper on page 491 states 52)
• A score >= 18 is associated with an increased risk of readmission.
An equation representing the data in Figure 1:
likelihood of readmission =
= (0.0002121 * ((score)^2)) + (0.008865 * (score)) + 0.07611
Performance:
• The area under the ROC curve is 0.67.
