Hospital staff education on severe sepsis/septic shock and hospital mortality: an original hypothesis |
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Authors: | Maurizia Capuzzo Marco Rambaldi Giovanni Pinelli Manuela Campesato Antonia Pigna Marco Zanello Maria Barbagallo Massimo Girardis Elena Toschi |
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Institution: | 1. Department of Anaesthesia, The Rotunda Hospital Dublin, Parnell Square, Dublin 1, Ireland 2. Royal College of Surgeons in Ireland, Dublin, Ireland 3. School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland 4. Mater Misericordiae University Hospital, Dublin, Ireland
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Abstract: | Background The Functional Comorbidity Index (FCI) was recently developed to predict physical function in acute lung injury patients using comorbidity data. Our objectives were to determine: (1) the inter-rater reliability of the FCI collected using in-patient discharge summaries (primary objective); and (2) the accuracy and predictive validity of the FCI collected using hospital discharge summaries and admission records versus complete chart review (secondary objectives). Methods For reliability, we evaluated the FCI’s intraclass correlation coefficient (ICC) among trained research staff performing data collection for 421 acute lung injury patients enrolled in a prospective cohort study. For validity and accuracy, we compared the detection of FCI comorbidities across three types of inpatient medical records, and the association of the respective FCI scores obtained with patients’ SF-36 physical function subscale (PFS) scores at 1-year follow-up. Results Inter-rater reliability was near-perfect (ICC 0.91; 95% CI 0.89-0.94). Hospital admission records and discharge summaries (vs. complete chart review) significantly underestimated the total FCI score. However, using multivariable linear regression, FCI scores collected using each of the three types of inpatient medical records had similar associations with PFS, suggesting similar predictive value. Conclusions Data collection using in-patient discharge summaries represents a reliable and valid method for collecting FCI comorbidity information. |
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