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Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index
06:55

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Published on: January 8, 2020

Use of the All Patient Refined-Diagnosis Related Group (APR-DRG) Risk of Mortality Score as a Severity Adjustor in

Daniel Baram1, Feroza Daroowalla, Ruel Garcia

  • 1Division of Pulmonary/Critical Care Medicine.

Clinical Medicine. Circulatory, Respiratory and Pulmonary Medicine
|December 16, 2010
PubMed
Abstract

Insights

The All Patient Refined-Diagnosis Related Group (APR-DRG) Risk of Mortality (ROM) score effectively predicts intensive care unit (ICU) mortality. This readily available score can be used for severity adjustment when other measures are unavailable.

Area of Science:

  • Critical Care Medicine
  • Health Services Research
  • Biostatistics

Background:

  • Assessing patient mortality risk in intensive care units (ICUs) is crucial for quality assessment and resource allocation.
  • Existing severity-adjustment tools, such as physiologic scoring systems, may not always be readily available.
  • The All Patient Refined-Diagnosis Related Group (APR-DRG) Risk of Mortality (ROM) score is a potential alternative for severity adjustment.

Purpose of the Study:

  • To evaluate the performance of the APR-DRG ROM score as a mortality risk adjustor in the ICU.
  • To determine the association between APR-DRG ROM scores and hospital mortality in an ICU population.

Main Methods:

  • Retrospective analysis of hospital mortality data.
  • Inclusion of 1213 patients admitted to a medical ICU at a university hospital between February 2004 and March 2006.
  • Statistical analysis including correlation and multiple logistic regression, adjusting for patient age and disease group.

Main Results:

  • A significant correlation was found between increasing APR-DRG ROM scores and mortality rate (p < 0.0001).
  • Multiple logistic regression confirmed that APR-DRG ROM was significantly associated with mortality risk.
  • A one-unit increase in APR-DRG ROM score was associated with a threefold increase in mortality risk.

Conclusions:

  • The APR-DRG ROM score demonstrates a strong correlation with ICU mortality.
  • This score is widely available for hospitalized patients globally.
  • APR-DRG ROM offers a practical, accessible method for severity adjustment, particularly when physiologic scoring is not feasible.
Keywords:
benchmarkinghospital mortalityintensive care unitrisk adjustmentseverity of illness scoring

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