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

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.