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 APACHE Ⅱ 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 APACHE Ⅱ score were higher in patients in Group A.The one-variable and multi-variable Logistic regression analyses showed that age,the WIC score,the APACHE Ⅱ 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 APACHE Ⅱ 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.
ABSTRACT
Objective To investigate the effect of common diseases by the Charlson weighted index of comorbidities(WIC) in predicting 1-year survival rate of older patients with rectum cancer.Methods Retrospective analyzed 160 patients with rectum cancer who were admitted in general surgery of Beijing Chaoyang Hospital Affiliated to Capital Medical University from Jun.2011 to May 2012.The patients were divided into two groups according to 1-year survival status:survival group (n =123) and death group (n =37).The data were recorded including age,gender,cancer diagnosis,underlying diseases,operation mode (laparoscopic or open) The WIC and the Acute physiology and chronic health Ⅱ (APACHE Ⅱ) score were calculated.Logistic regression analysis was used to determine the independent predictors for 1-year survival rate.Receiver operating characteristics(ROC) curve was used to evaluate the value of WIC in predicting 1-year survival rate.Results Of the 160 patients,123 cases survived,37 cases died at 1 year after treatment.WIC score and APACHE score in death group were (2.2 ± 1.3) and (11.5 ± 5.1),higher than those of survival group (1.3 ± 1.2,9.5 ± 4.3 ;P =0.021,0.014).Multivariate Logistic regression analysis indicated that age,mode of operation,WIC score and APACHE score were related to the 1-year survival status of patients with rectal cancer(OR(95％ CI):1.053 (1.018-1.178,1.021 (1.011-1.906),1.786 (1.203-2.235),1.019 (1.004-1.628).ROC curve area of forecasting of death of the WIC score,APACHE Ⅱ score and the combination of the two are 0.731,0.828,0.959.Conclusion The WIC scoring system can be a good evaluation method for 1-year survival rate in old patients with rectum cancer.
