Description

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%

 


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