title: The Patient- And Nutrition-Derived Outcome Risk Assessment Score (PANDORA): Development of a Simple Predictive Risk Score for 30-Day In-Hospital Mortality Based on Demographics, Clinical Observation, and Nutrition.
abstract: OBJECTIVE
  To develop a simple scoring system to predict 30 day in-hospital mortality of in-patients excluding those from intensive care units based on easily obtainable demographic, disease and nutrition related patient data.
  
  
  METHODS
  Score development with general estimation equation methodology and model selection by P-value thresholding based on a cross-sectional sample of 52 risk indicators with 123 item classes collected with questionnaires and stored in an multilingual online database.
  
  
  METHODS
  Worldwide prospective cross-sectional cohort with 30 day in-hospital mortality from the nutritionDay 2006-2009 and an external validation sample from 2012.
  
  
  RESULTS
  We included 43894 patients from 2480 units in 32 countries. 1631(3.72%) patients died within 30 days in hospital. The Patient- And Nutrition-Derived Outcome Risk Assessment (PANDORA) score predicts 30-day hospital mortality based on 7 indicators with 31 item classes on a scale from 0 to 75 points. The indicators are age (0 to 17 points), nutrient intake on nutritionDay (0 to 12 points), mobility (0 to 11 points), fluid status (0 to 10 points), BMI (0 to 9 points), cancer (9 points) and main patient group (0 to 7 points). An appropriate model fit has been achieved. The area under the receiver operating characteristic curve for mortality prediction was 0.82 in the development sample and 0.79 in the external validation sample.
  
  
  CONCLUSIONS
  The PANDORA score is a simple, robust scoring system for a general population of hospitalised patients to be used for risk stratification and benchmarking.
authors.affiliation: Department of Anaesthesiology, General Intensive Care and Pain Control, Division Cardiac-, Thoracic-, Vascular Anaesthesia and Intensive Care, Medical University Vienna, Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Hiesmayr
authors.affiliation: Center for Medical Statistics, Informatics and Intelligent Systems, Section for Medical Statistics, Vienna, Austria.
authors.forename: Sophie
authors.initials: S
authors.lastname: Frantal
authors.affiliation: Medical Clinic III, Division Endocrinology, Medical University Vienna, Vienna, Austria.
authors.forename: Karin
authors.initials: K
authors.lastname: Schindler
authors.affiliation: Center for Medical Statistics, Informatics and Intelligent Systems, Section for Medical Statistics, Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Themessl-Huber
authors.affiliation: Department of Anaesthesiology, General Intensive Care and Pain Control, Division Cardiac-, Thoracic-, Vascular Anaesthesia and Intensive Care, Medical University Vienna, Vienna, Austria.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Mouhieddine
authors.affiliation: Center for Medical Statistics, Informatics and Intelligent Systems, Section for Medical Statistics, Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Schuh
authors.affiliation: Center for Medical Statistics, Informatics and Intelligent Systems, Section for Medical Statistics, Vienna, Austria.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Pernicka
authors.affiliation: Nutritional Support Unit, Pôle Digestif, Hôpital de l'Archet, Nice, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Schneider
authors.affiliation: General Intensive Care Department, Rabin Medical Center University Hospital, Beilinson Campus, Petah Tiqwa, Israel.
authors.forename: Pierre
authors.initials: P
authors.lastname: Singer
authors.affiliation: Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
authors.forename: Olle
authors.initials: O
authors.lastname: Ljunqvist
authors.affiliation: Clinical Nutrition, Geneva University Hospital, Geneva, Switzerland.
authors.forename: Claude
authors.initials: C
authors.lastname: Pichard
authors.affiliation: Department of Clinical Medicine, University La Sapienza, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Laviano
authors.affiliation: Department of Anaesthesiology, General Intensive Care and Pain Control, Division Cardiac-, Thoracic-, Vascular Anaesthesia and Intensive Care, Medical University Vienna, Vienna, Austria.
authors.forename: Sigrid
authors.initials: S
authors.lastname: Kosak
authors.affiliation: Center for Medical Statistics, Informatics and Intelligent Systems, Section for Medical Statistics, Vienna, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Bauer
mesh_terms: D000367:Age Factors; D017052:Hospital Mortality; D006801:Humans; D063868:Patient Outcome Assessment; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012306:Risk; D018570:Risk Assessment; D012720:Severity of Illness Index