• M O Opio, G Mutiibwa, J Kellett, M Brabrand, and Kitovu Hospital Study Group.
• Kitovu Hospital, Masaka, Uganda.
• QJM. 2017 Sep 1; 110 (9): 545-549.

BackgroundAlthough asking how a patient feels is the first enquiry most clinicians make the value of the answer has never been examined in acutely ill patients.MethodsProspective observational study that compared the predictive value of how well acutely ill medical patients felt after admission to a resource poor sub-Saharan hospital with their mental alertness, mobility and vital signs.ResultsIn total, 403 patients were studied. Patients who felt better when re-assessed 18.0 SD 9.1 h after admission to hospital were less likely to die in hospital (OR 0.18 95% CI 0.08-0.43, P = 0.00001) and more likely to be independent of others at discharge (OR 5.64 95% CI 3.04-10.47, P = 0.00001). Feeling better was an independent predictor of in-hospital death along with vital sign changes and gait stability, and an independent predictor of independence at discharge along with vital sign changes, gait stability and female gender.ConclusionIn this patient cohort a subjective feeling of improvement at the first re-assessment after admission to hospital is a powerful independent predictor of reduced in-hospital mortality.© The Author 2017. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com

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