Demographic, clinical, laboratory features and results were presented as mean standard deviation (SD) for quantitative variables (age, birth weight and duration of therapy) and as frequencies and percentages for qualitative variables (gender, gestational age at birth, admitting diagnosis
, risk factors for MDROs, pathogens isolated, clinical spectrum of disease, treatment modalities and mortality).
Based on the review of literature and available data from chart review, the following variables were included in the study: 1) child's age, 2) child's weight, 3) admitting diagnosis
, 4) other diagnoses, 5) length of time with a CVAD, 6) CVAD insertion site (upper extremity or lower extremity), 7) catheter brand, 8) ultrasound-guided CVAD insertion, 9) catheter size, 10) number of lumens, 11) laboratory values (sedimentation rate, C-reactive protein [CRP], prothrombin time [PT], partial thromboplastin time [PTT], D-dimer, fibrinogen level, factor VIII, lactic acid, complete blood count [CBC]), 12) family history of VTE, 13) history of VTE, 14) length of stay, 15) documented preventative VTE measures, and 16) surgical procedures.
Patient variables included gender identity, age, ethnicity, type of insurance, admitting diagnosis
, comorbidities, discharge disposition, previous ED visit or hospitalization within the last 30 days, admitting location, LOS, and specialty consults.
For example: A patient with multilobe pneumonia is admitted with hypoxemia and low blood pressure, but the admitting diagnosis
is simply listed as pneumonia, without acknowledging the presence of respiratory failure or septic shock.
The results of the Israeli study were startling: In the 3 years prior to introduction of the vaccines, one in five children under age 2 years admitted to the hospital had as an admitting diagnosis
either rotavirus gastroenteritis confirmed by a positive stool ELISA test or pneumococcal pneumonia as evidenced by alveolar pneumonia on chest x-ray.
Patients presenting to CCU with typical chest pain, pain epigastrium, sweating, nausea or vomiting and with admitting diagnosis
of acute coronary syndrome (ACS) were included.
4% of the transfers there was agreement between the discharge diagnosis at the referring hospital and the admitting diagnosis
assigned at the receiving hospital.
Attributes Selected in 100 Classification Iterations Accuracy Primary diagnosis 61% Primary diagnosis, primary 67% procedure Primary diagnosis, primary 69% procedure, admitting diagnosis
Primary diagnosis, primary 70% procedure, admitting diagnosis
, DRG Table 1: Length of Hospital Stay.
7) Admitting diagnosis
Musculoskeletal 26 (39%) 7 (33%) Cardiopulmonary 18 (27%) 4 (19%) Gastrointestinal/genitourinary 8 (12%) 5 (24%) Central nervous system 9 (14%) 3 (14%) Trauma 1 (2%) 0 Infections 3 (5%) 1 (5%) Other 1 (2%) 1 (5%) Co-morbidities Musculoskeletal 14 (21%) 10 (48%) Cardiopulmonary 52 (79%) 19 (90%) (primarily hypertension) Central nervous system 12 (18%) 8 (38%) Gastrointestinal/genitourinary 13 (20%) 7 (33%) Cancer 8 (12%) 10 (48%) Diabetes mellitus 14 (21%) 6 (29%) Osteoporosis 2 (3%) 1 (5%) Thyroid abnormalities 9 (14%) 2 (10%) Other 18 (27%) 4 (19%) (rheumatologic, hematologic) Length of therapy duration (days) 2.
Of particular interest, Chapter 8 of the Manual states that a patient admitted to an SNF should have his/her admitting diagnosis
and principal diagnosis (the main reason for continued care) recorded as V codes.
The patient was transported to our intensive care unit with an admitting diagnosis
of coma and DKA complicated with pneumonia.
Documented risk factors included primary admitting diagnosis
, previous potential exposure to hospital-acquired pneumonia, and the Acute Physiology and Chronic Health Evaluation (APACHE) II score, a severity of disease classification system (Knaus, Draper, Wagner, & Zimmerman, 1985).