Overstay Predictor Diagnosis Code Used

Legacy Data only - see List of diagnoses affecting Overstay Project 

The Overstay Predictor Project uses a number of diagnoses as indicators whether a patient would be likely to overstay due to difficulty in discharging. The following diagnoses are included to accomplish this.

Diagnoses used in analysis and by CCMDB.mdb to generate chart colour

CNSI Admit Dxs

These are used to generate a "CNSI_any" (Central Nervous System Injury) variable

• 502 ICH
• 503 SAH
• 504 Brain Stem Hemorrhage
• 505-0 CVA
• 505-1 CVA post angio
• 505-2 CVA post op
• 505-3 CVA post trauma
• 505-4 CVA post anticoagulation therapy
• 505-5 CVA intra-op
• 505-6 CVA post partum
• 505-7 CVA super sagittal sinus
• 505-8 CVA brainstem
• 505-90 CVA 2nd to other PROCEDURES
• 506 Tentorial_Herniation
• 529 Post Traumatic Quadriplegia
• 537 Paraplegia, Hemiplegia due to any condition
• 599-4 Cerebral Infarct Cause NYD
• 599-5 Quadraparesis-Post OP
• 599-6 Traumatic Paralysis 2nd to Spinal Subdural Bleed
• 599-18 Spinal Cord Infarct
• 603 SAH - Subarachnoid - POST OP (see: 647 for NON POST OP)
• 609 C-spine trauma WITH cord injury
• 611 T-spine WITH cord injury
• 613 L-spine WITH cord injury
• 647 SAH Subarachnoid-NON POST OP
• 648 Brainstem Hemorrhage-NON POST OP craniotomy
• 695 Diffuse axonal injury (likely be in an ICU not med ward)
• 983 CVA (stroke) due to central line insertion

Dementia

Generally we don't want comorbids for this analysis because it is assumed that the patient was able to cope with the condition from home. However, apparently dementia having progressed to a non-functioning level is often the reason why a patient is hard to discharge. Therefore, the following being present as either Admit or Comorbidity are also included:

• 526 Dementia
• 538 Violent 2nd to dementia

other comorbids

The Overstay Predictor model also uses the charlson comorbid score, so include all charlson comorbids.

No Acquired Diagnoses!

No acquired diagnoses will be included in the analysis; acquire diagnoses would not be available at the time that we need to make this prediction. We need to exclude acquired dxs from the dataset given to Rodrigo and provide it again.

Currently unused diagnoses that might cause overstay

The overstay team is aware that some other diagnoses might also cause discharge delays. If you come across some that we missed, please add them below, with a reason why they should be included. We will review the algorithm over time and might decide to include these at that time.

• e.g. diagnosis
  • e.g. reason to include
• Linda, you may want to consider patients that have muscle deconditioning. This can be caused by a variety of reasons, like poor nutrition for any reason,(short gut syndrome, cancer, colitis, etc.) long ICU stay just prior to admission to the ward, being on bedrest or basically being less mobile for any reason. Another diagnosis that also reflects this would be lower limb amputation patients.
• People with extremely limited exercise tolerance may also include cardiomyopathy patients with class 4 SOB and end stage or severe COPD patients, metastatic cancer patients--LKolesar 15:14, 2012 November 30 (EST)
• Perhaps may want to consider all patients who are wheelchair bound for any reason (cerebral palsy, bilateral lower limb amputees, hip or knee issues, etc).