The Relationship Between Severity of Illness and Hospital Length of Stay and Mortality

Bibliographic Data

ID9097724
AuthorsSusan D Horn (0000-0003-0199-4513, Johns Hopkins University, corresponding author), Phoebe D Sharkey (0000-0001-9259-7286, Loyola University Maryland), June M Buckle (Johns Hopkins University, corresponding author), Joanne E Backofen, Richard F Averill, Roger A Horn (0000-0003-1307-2938, Johns Hopkins University)
Year1991
Volume29
Issue4
Pages305-317
Publication date1991-04-01
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-199104000-00001
PMID1902275
OpenAlexW1993603054
LanguageEN
Citations received10
References cited2

To address the question of quantification of severity of illness on a wide scale, the Computerized Severity Index (CSI) was developed by a research team at the Johns Hopkins University. This article describes an initial assessment of some aspects of the validity and reliability of the CSI on a sample of 2,378 patients within 27 high-volume DRGs from five teaching hospitals. The 27 DRGs predicted 27% of the variation in LOS, while DRGs adjusted for Admission CSI scores predicted 38% and DRGs adjusted for Maximum CSI scores throughout the hospital stay predicted 54% of this variation. Thus, the Maximum CSI score increased the predictability of DRGs by 100%. We explored the impact of including a 7-day cutoff criterion along with the Maximum CSI score similar to a criterion used in an alternative severity of illness measure. The DRG/Maximum CSI score's predictive power increased to 63% when the 7-day cutoff was added to the CSI definition. The Admission CSI score was used to predict in-hospital mortality and correlated R = 0.603 with mortality. The reliability of Admission and Maximum CSI data collection was high, with agreement of 95% and kappa statistics of 0.88 and 0.90, respectively

Cutoff · Illness severity · Power (physics) · Predictability · Predictive power · Reliability (semiconductor) · Sample size determination · Severity of illness · Statistics · Emergency and Acute Care Studies · Emergency Medicine · Healthcare Policy and Management · Internal Medicine · Mathematics · Medicine · Sepsis Diagnosis and Treatment

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