Wang, JW;
Smith, P;
Sarker, S-J;
Elands, S;
Oliveira, A;
Barratt, C;
Thorn, C;
... Lynch, M; + view all
(2019)
Can Waterlow score predict 30-day mortality and length of stay in acutely admitted medical patients (aged ≥65 years)? Evidence from a single centre prospective cohort study.
BMJ Open
, 9
(11)
, Article e032347. 10.1136/bmjopen-2019-032347.
Preview |
Text
Waterlow score.pdf - Published Version Download (311kB) | Preview |
Abstract
OBJECTIVE: This study aimed to explore the potential for the Waterlow score (WS) to be used as a predictor of 30-day mortality and length of hospital stay (LHS) in acutely admitted medical patients aged 65 years and older. DESIGN: Prospective observational cohort study. SETTING: UK District General Hospital. SUBJECTS: 834 consecutive patients aged 65 years and older admitted acutely to medical specialties between 30 May and 22 July 2014. METHODS ADMISSION: WS (range 4–64) assessment paired with the patient’s status at 30 days in terms of mortality and their LHS. PRIMARY OUTCOMES: 30-day mortality and length of inpatient stay. RESULTS: 834 consecutive acute medical admissions had their WS recorded. 30-day mortality was 13.1% (109 deaths). A significant difference in the distribution of WS (p<0.001) was seen between those who survived (median 12) and those who died (median 16) within 30 days, particularly within respiratory (p<0.001), stroke (p<0.001), cardiology (p<0.016), non-respiratory infections (p<0.018) and trauma (p<0.044) subgroups. Odds of dying within 30 days increased threefold for every 10-unit increase in the WS (p<0.001, 95% CI 2.1 to 4.3). LHS was also positively linearly associated with the WS in those who survived 30 days (median=5, IQR=10; r=0.32, p<0.01). A five-unit increase in WS was associated with approximately 5 days increase in LHS. On the other hand, quadratic regression showed this relationship was curvilinear and negative (concave) for those who died within 30 days where a five-unit increase in WS was associated with an approximately 10 days decrease in LHS. CONCLUSION: This study demonstrates an association between a high WS and both 30-day mortality and LHS. This is particularly significant for mortality in patients in the respiratory, stroke and cardiac subcategories. The WS, a nursing-led screening tool that is carried out on virtually all admissions to UK hospitals, could have additional use at the time of patient admission as a risk assessment tool for 30-day mortality as well as a predictor of LHS.
| Type: | Article |
|---|---|
| Title: | Can Waterlow score predict 30-day mortality and length of stay in acutely admitted medical patients (aged ≥65 years)? Evidence from a single centre prospective cohort study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/bmjopen-2019-032347 |
| Publisher version: | https://doi.org/10.1136/bmjopen-2019-032347 |
| Language: | English |
| Additional information: | This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10088719 |
Archive Staff Only
 |
View Item |
