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

Clin Med Circ Respirat Pulm Med. 2008 Apr 18;2:19-25. doi: 10.4137/ccrpm.s544.

Abstract

Objective: To evaluate the performance of APR-DRG (All Patient Refined-Diagnosis Related Group) Risk of Mortality (ROM) score as a mortality risk adjustor in the intensive care unit (ICU).

Design: Retrospective analysis of hospital mortality.

Setting: Medical ICU in a university hospital located in metropolitan New York.

Patients: 1213 patients admitted between February 2004 and March 2006.

Main results: Mortality rate correlated significantly with increasing APR-DRG ROM scores (p < 0.0001). Multiple logistic regression analysis demonstrated that, after adjusting for patient age and disease group, APR-DRG ROM was significantly associated with mortality risk in patients, with a one unit increase in APR-DRG ROM associated with a 3-fold increase in mortality.

Conclusions: APR-DRG ROM correlates closely with ICU mortality. Already available for many hospitalized patients around the world, it may provide a readily available means for severity-adjustment when physiologic scoring is not available.

Keywords: benchmarking; hospital mortality; intensive care unit; risk adjustment; severity of illness scoring.