Zapatero et al developed an index for prediction of readmission to the hospital for adults on an internal medicine ward. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple hospitals in Madrid.
SEMI is an acronym for Sociedad Espanola Medicina Interna.
Patient selection: adult on an internal medicine ward
|
Age Group |
Global Risk of Readmission |
|
<= 50 |
8.6% |
|
51 to 70 |
12.2% |
|
71 to 90 |
13.6% |
|
> 90 |
11.1% |
Parameters:
(1) sex
(2) length of current admission above median
(3) severe liver disease
(4) exacerbation of COPD
(5) malnutrition
(6) cancer
(7) chronic renal insufficiency
(8) acute congestive heart failure
(9) anemia
(10) diabetes
(11) dementia
(12) atrial fibrillation
Age Range: <= 50 Years
|
Parameter |
Finding |
Points |
|
sex |
female |
0 |
|
|
male |
1 |
|
length of current stay |
at or below median |
0 |
|
|
above median |
1 |
|
severe liver disease |
absent |
0 |
|
|
present |
5 |
|
exacerbation of COPD |
absent |
0 |
|
|
present |
1 |
|
malnutrition |
absent |
0 |
|
|
present |
2 |
|
cancer |
absent |
0 |
|
|
present |
5 |
|
chronic renal insufficiency |
absent |
0 |
|
|
present |
3 |
|
acute congestive heart failure |
absent |
0 |
|
|
present |
1 |
|
anemia |
absent |
0 |
|
|
present |
1 |
|
diabetes |
absent |
0 |
|
|
present |
0 |
|
dementia |
absent |
0 |
|
|
present |
5 |
|
atrial fibrillation |
absent |
0 |
|
|
present |
0 |
Age Range: 51 to 70 Years
|
Parameter |
Finding |
Points |
|
sex |
female |
0 |
|
|
male |
1 |
|
length of current stay |
at or below median |
0 |
|
|
above median |
1 |
|
severe liver disease |
absent |
0 |
|
|
present |
7 |
|
exacerbation of COPD |
absent |
0 |
|
|
present |
3 |
|
malnutrition |
absent |
0 |
|
|
present |
2 |
|
cancer |
absent |
0 |
|
|
present |
6 |
|
chronic renal insufficiency |
absent |
0 |
|
|
present |
4 |
|
acute congestive heart failure |
absent |
0 |
|
|
present |
3 |
|
anemia |
absent |
0 |
|
|
present |
2 |
|
diabetes |
absent |
0 |
|
|
present |
1 |
|
dementia |
absent |
0 |
|
|
present |
4 |
|
atrial fibrillation |
absent |
0 |
|
|
present |
0 |
Age Range: 71 to 90 Years
|
Parameter |
Finding |
Points |
|
sex |
female |
0 |
|
|
male |
1 |
|
length of current stay |
at or below median |
0 |
|
|
above median |
1 |
|
severe liver disease |
absent |
0 |
|
|
present |
6 |
|
exacerbation of COPD |
absent |
0 |
|
|
present |
3 |
|
malnutrition |
absent |
0 |
|
|
present |
3 |
|
cancer |
absent |
0 |
|
|
present |
3 |
|
chronic renal insufficiency |
absent |
0 |
|
|
present |
2 |
|
acute congestive heart failure |
absent |
0 |
|
|
present |
2 |
|
anemia |
absent |
0 |
|
|
present |
2 |
|
diabetes |
absent |
0 |
|
|
present |
1 |
|
dementia |
absent |
0 |
|
|
present |
1 |
|
atrial fibrillation |
absent |
0 |
|
|
present |
1 |
Age Range: > 90 Years
|
Parameter |
Finding |
Points |
|
sex |
female |
0 |
|
|
male |
1 |
|
length of current stay |
at or below median |
0 |
|
|
above median |
1 |
|
severe liver disease |
absent |
0 |
|
|
present |
4 |
|
exacerbation of COPD |
absent |
0 |
|
|
present |
3 |
|
malnutrition |
absent |
0 |
|
|
present |
2 |
|
cancer |
absent |
0 |
|
|
present |
0 |
|
chronic renal insufficiency |
absent |
0 |
|
|
present |
1 |
|
acute congestive heart failure |
absent |
0 |
|
|
present |
1 |
|
anemia |
absent |
0 |
|
|
present |
1 |
|
diabetes |
absent |
0 |
|
|
present |
2 |
|
dementia |
absent |
0 |
|
|
present |
1 |
|
atrial fibrillation |
absent |
0 |
|
|
present |
2 |
total score =
= SUM(points for all 12 parameters)
Interpretation:
• minimum score: 0
• maximum score for <= 50 years: 25
• maximum score for 50 t0 70 years: 34
• maximum score for 71 to 90 years: 26
• maximum score for > 90 years: 19
|
Risk Group |
<= 50 Years |
51 to 70 Years |
71 to 90 Years |
> 90 Years |
|
low |
0 to 3 |
0 to 5 |
0 to 5 |
0 to 5 |
|
moderate |
4 to 6 |
6 to 9 |
6 to 9 |
6 to 8 |
|
high |
>= 7 |
>= 10 |
>= 10 |
>= 9 |
Predicted rates of readmission
|
Risk Group |
<= 50 Years |
51 to 70 Years |
71 to 90 Years |
> 90 Years |
|
low |
7.4% |
9.7% |
11.6% |
10% |
|
moderate |
13.9% |
17% |
16.3% |
13.4% |
|
high |
22.2% |
22% |
21.2% |
17.1% |
