title: Simple clinical score is associated with mortality and length of stay of acute general medical admissions to an Australian hospital.
abstract: BACKGROUND
  In a rural Irish hospital, a simple clinical score (SCS) determined at the time of admission enabled stratification of acute general medical admissions into five categories that were associated incrementally with patients' immediate and 30-day mortality. The aim of this study was to examine the representative performance of this SCS in predicting the outcomes of general medical admissions to an Australian teaching hospital.
  
  
  METHODS
  A retrospective chart review was undertaken of a representative sample from 480 admissions in 2007 to an urban university teaching hospital in Australia. The SCS was calculated and related to that patient's outcome in terms of mortality, length of stay, nursing home placement on discharge, the occurrence of medical emergency team call and intensive care unit transfer. These data were compared, where possible, with the outcomes reported in the Irish hospital.
  
  
  RESULTS
  Four hundred and seventeen complete sets of data allowed calculation of the SCS. There were significant linear correlations of the SCS (divided into quintiles) and patients' in-hospital and 30-day mortality, their length of stay and their discharge to a nursing home. There was no association of the SCS and the patients' readmission rate, intensive care unit transfer rate or likelihood of a medical emergency team call. The significant trends replicated those from the Irish hospital.
  
  
  CONCLUSIONS
  The SCS can predict significant outcomes for general medical admissions in an Australian hospital despite obvious differences to the hospital of its derivation. A wider study of Australasian hospitals and the performance of the SCS as a predictor of general medical admission outcomes is underway.
authors.affiliation: Department of General Medicine, Flinders Medical Centre School of Medicine, Flinders University University of Adelaide, Adelaide, South Australia, Australia. jordan.li@health.sa.gov.au
authors.forename: J Y Z
authors.initials: JY
authors.lastname: Li
authors.forename: T Y
authors.initials: TY
authors.lastname: Yong
authors.forename: P
authors.initials: P
authors.lastname: Hakendorf
authors.forename: S
authors.initials: S
authors.lastname: Roberts
authors.forename: L
authors.initials: L
authors.lastname: O'Brien
authors.forename: Y
authors.initials: Y
authors.lastname: Sharma
authors.forename: D
authors.initials: D
authors.lastname: Ben-Tovim
authors.forename: C H
authors.initials: CH
authors.lastname: Thompson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization / Q000639:trends; D006784:Hospitals, Teaching / Q000639:trends; D006801:Humans; D007902:Length of Stay / Q000639:trends*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000639:trends*; D012189:Retrospective Studies; D012720:Severity of Illness Index