• E O'Sullivan, E Callely, D O'Riordan, K Bennett, and B Silke.
• Department of Internal Medicine, St James's Hospital, Dublin 8 ,Ireland.
• Acute Med. 2012 Jan 1;11(2):59-65.

BackgroundThe utility of risk stratification following an emergency medical admission has been debated. We have examined the predictability of outcomes, from a database of all emergency admissions to St James' Hospital, Dublin, over a six year period (2005-2010).MethodsAnalysis was performed using the hospital in-patient enquiry system, linked to the patient administration system and laboratory data. The utility of a fractional polynomial laboratory only model to predict 30-day in-hospital mortality was determined.ResultsThe AUROC for the laboratory parameters to predict a 30 day death was 0.90 ( 95% CI 0.89, 0.90) in the 2002 - 2010 derivation dataset and was 0.88 (95% CI 0.86, 0.90) in the 2011 validation set. The addition of co-morbidity measures did not improve the model prediction (0.89 : 95% CI 0.88 - 0.89).ConclusionA fractional polynomial laboratory only model can reliably predict 30-day hospital mortality following an emergency medical admission, potentially allowing resources to be risk focused and patients to be prioritised.

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