The use of Charlson weighted index to evaluate the time of observation in emergency internal observation room

Abstract

Objective To investigate the role of underlying diseases in predicting the length of stay for observation in emergency department of internal medicine by the Charlson weighted index of comorbidities(WIC) . Methods A single-center retrospective analysis of clinical data of 2 836 patients admitted in emergency observation room of the Beijing Chaoyang Hospital from January 1 to June 30 in 2013 was carried out. The patients were divided into two groups according to the length of observation time: Group A (time of observation ≥72 h, n =1908) and Group B (time of observation <72 h, n =928) . The data of the length of observation time were recorded, and the WIC and the APACHEⅡ score were calculated. Logistic regression analysis was used to determine the independent predictors for 72-hour observation. Receiver operating characteristics (ROC) curve was used to evaluate the value of WIC in predicting 72-hour observation. Results Of 2836 patients, 1176 (41.5%) suffered from respiratory disease, 709 (25.0%) had cardiovascular and cerebrovascular diseases, 423 (14.9%) were contracted digestive system disease, 251 (8.8%) had renal and endocrinology system diseases and 277 (9.8%) had diseases arisen from physicochemical factor and miscellaneous causes. Compared with patients in Group B, the average age, the number of elderly patients residing in apartment exclusively for elderly, the WIC and the APACHEⅡ score were higher in patients in Group A. The one-variable and multi-variable Logistic regression analyses showed that age, the WIC score, the APACHEⅡ score and residing in apartment for elderly people were related with 72-hour observation in emergency observation room. The area under the ROC curve in predicting 72-hour observation was 0.701 for the WIC score, 0.788 for APACHEⅡ score and 0.853 for their combination. Conclusions The WIC scoring system can be a good predicting method for 72-hour observation in patients in emergency observation room.. Key words: Emergency; Charlson weighted index of comorbidities scoring system; Receiver operating characteristics curve; Underlying disease; Logistic regression analysis; Age; Acute physiology and chronic health evaluation; Predicting