General characteristics of admissions by cohort
| Patient characteristics | Number (%) of admissions* | P value† | Univariable analysis | ||
| Derivation set, n=62 280 | Validation set, n=30 579 | OR (95% CI) | P value† | ||
| Outcomes | |||||
| Hospital mortality | 773 (1.2) | 385 (1.3) | 0.8177 | ||
| Discharge to hospice | 510 (0.8) | 226 (0.7) | 0.1974 | ||
| Covariates | |||||
| Married | 40 825 (65.6) | 19 734 (64.5) | 0.0022 | 0.94 (0.84 to 1.06) | 0.3125 |
| DNR/DNI code | 3832 (6.15) | 1917 (6.27) | 0.4901 | 7.22 (6.37 to 8.17) | <0.0001 |
| White (race) | 57 472 (92.3) | 28 240 (92.4) | 0.7031 | 0.93 (0.76 to 1.13) | 0.4625 |
| Geographic area | 0.7005 | <0.0001 | |||
| Olmsted County (reference) | 13 102 (21.0) | 6503 (21.3) | 1.00 | ||
| National | 36 370 (58.4) | 17 827 (58.3) | 0.79 (0.68 to 0.90) | <0.0001 | |
| Southeastern Minnesota | 12 808 (20.6) | 6249 (20.4) | 1.16 (0.99 to 1.36) | <0.0001 | |
| Predictors | |||||
| IPFS at 24 hours, median (IQR) | 9 (4–9) | 9 (4–9) | 0.2775 | 1.13 (1.12 to 1.15) | <0.0001 |
| Male | 31 103 (49.9) | 15 288 (50.0) | 0.8759 | 1.20 (1.07 to 1.34) | 0.0015 |
| Age (years), median (IQR) | 61 (47–73) | 61 (47–73) | 0.5688 | 1.04 (1.04 to 1.05) | <0.0001 |
| Surgical patient | 32 595 (52.3) | 16 029 (52.4) | 0.8139 | 0.31 (0.27 to 0.35) | <0.0001 |
| Charlson Comorbidity Index, median (IQR) | 1 (0–2) | 1 (0–2) | 0.4618 | 1.72 (1.66 to 1.77) | <0.0001 |
| Congestive heart failure | 7349 (11.8) | 3609 (11.8) | 0.9919 | 3.10 (2.74 to 3.51) | <0.0001 |
| Liver disease | 4555 (7.3) | 2179 (7.1) | 0.2994 | 3.27 (2.77 to 3.76) | <0.0001 |
| Diabetes | 11 785 (18.9) | 5641 (18.4) | 0.0813 | 1.47 (1.30 to 1.68) | <0.0001 |
| Malignancy | 11 006 (17.7) | 5390 (17.6) | 0.8648 | 3.98 (3.55 to 4.46) | <0.0001 |
| Hemiplegia | 1490 (2.4) | 715 (2.3) | 0.6101 | 3.38 (2.72 to 4.19) | <0.0001 |
| Braden activity | missing=215 | missing=140 | 0.2057 | <0.0001 | |
| Frequent walks | 25 573 (41.2) | 12 592 (41.4) | 0.17 (0.18 to 0.27) | <0.0001 | |
| Occasional walks (reference) | 20 633 (33.2) | 10 155 (33.4) | 1.00 | ||
| Chairfast | 3906 (6.3) | 1806 (5.9) | 2.03 (1.73 to 2.40) | <0.0001 | |
| Bedfast | 11 953 (19.3) | 5886 (19.3) | 1.27 (1.12 to 1.45) | 0.0883 | |
| Braden nutrition | missing=215 | missing=140 | 0.4679 | < 0.0001 | |
| Excellent | 13 534 (21.8) | 6687 (22.0) | 0.29 (0.22 to 0.39) | <0.0001 | |
| Adequate (reference) | 32 774 (52.8) | 16 120 (53.0) | 1.00 | ||
| Inadequate | 14 305 (23.0) | 6965 (22.9) | 3.27 (2.89 to 3.71) | <0.0001 | |
| Very poor | 1452 (2.3) | 667 (2.2) | 9.88 (8.21 to 11.9) | <0.0001 | |
| Hendrich II Fall Risk, median (IQR) | 2 (1–4) | 2 (1–4) | 0.0704 | 1.33 (1.30 to 1.35) | <0.0001 |
| Modified RASS | Missing=102 | Missing=68 | 0.0120 | <0.0001 | |
| Sedated | 5738 (9.2) | 2768 (9.1) | 4.30 (3.79 to 4.89) | <0.0001 | |
| Normal (reference) | 54 428 (87.5) | 26 889 (88.1) | 1.00 | ||
| Agitated | 2012 (3.2) | 884 (2.8) | 4.13 (3.39 to 5.04) | <0.0001 | |
*Unless otherwise specified as median (IQR).
†Pearson χ2 test for categorical variables and t-test for continuous variables: P value <0.001 is significant.
DNR/DNI Code, do not resuscitate/do not intubate status; IPFS, Inpatient Physiologic Failure Score; RASS, Richmond Agitation Sedation Scale.