@article{ea393244115642e6bd67faa4889fc215,
title = "The Accuracy of Interqual Criteria in Determining the Observation versus Inpatient Status in Older Adults with Syncope",
abstract = "Background: McKesson's InterQual criteria are widely used in hospitals to determine if patients should be classified as observation or inpatient status, but the accuracy of the criteria is unknown. Objective: We sought to determine whether InterQual criteria accurately predicted length of stay (LOS) in older patients with syncope. Methods: We conducted a secondary analysis of a cohort study of adults ≥60 years of age who had syncope. We calculated InterQual criteria and classified the patient as observation or inpatient status. Outcomes were whether LOS were less than or greater than 2 midnights. Results: We analyzed 2361 patients; 1227 (52.0%) patients were male and 1945 (82.8%) were white, with a mean age of 73.2 ± 9.0 years. The median LOS was 32.6 h (interquartile range 24.2–71.8). The sensitivity of InterQual criteria for LOS was 60.8% (95% confidence interval 57.9–63.6%) and the specificity was 47.8% (95% confidence interval 45.0–50.5%). Conclusions: In older adults with syncope, those who met InterQual criteria for inpatient status had longer LOS compared with those who did not; however, the accuracy of the criteria to predict length of stay over 2 days is poor, with a sensitivity of 60% and a specificity of 48%. Future research should identify criteria to improve LOS prediction.",
keywords = "InterQual, case management, geriatrics, syncope",
author = "Chang, {Anna Marie} and Hollander, {Judd E.} and Erica Su and Weiss, {Robert E.} and Yagapen, {Annick N.} and Malveau, {Susan E.} and Adler, {David H.} and Aveh Bastani and Baugh, {Christopher W.} and Caterino, {Jeffrey M.} and Clark, {Carol L.} and Diercks, {Deborah B.} and Nicks, {Bret A.} and Nishijima, {Daniel K.} and Shah, {Manish N.} and Stiffler, {Kirk A.} and Storrow, {Alan B.} and Wilber, {Scott T.} and Sun, {Benjamin C.}",
note = "Funding Information: Research reported in this publication was supported by National Heart, Lung, and Blood Institute grant number R01HL111033 . The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. The contents do not necessarily represent the official views of the National Institutes of Health. ClinicalTrials.gov identifier: NCT01802398 (available at https://clinicaltrials.gov/ct2/show/results/NCT01802398?view=results ). Dr. Chang has received funding from Ortho Diagnostics, Bristol Meyers Squibb, Abbott , Roche , Entegrion, Nanomix, Alere , the National Institutes of Health , and the Patient-Centered Outcomes Research Institute . Dr. Hollander's institution has received grant funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health and contract funding from Alere , Siemens , Roche , and Trinity for industry-initiated research institutional research. Dr. Clark's institution has received grant funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health and contract funding from Radiometer and Ortho Scientific for industry-initiated research. TAG's institution has received grant funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health . Dr. Weiss' institution has received grant funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health . Dr. Yagapen's institution has received grant funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health . Dr. Malveau's institution has received grant funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health . Dr. Adler's institution has received grant funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health institution and has received contract funding for industry-initiated research from Roche . Dr. Bastani's institution has received grant funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health and contract funding from Radiometer and Ortho Scientific for industry-initiated research. Dr. Baugh's institution has received grant funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health , and Dr. Baugh has received funding from Roche for speaking and Janssen Pharmaceuticals for advisory board participation. Dr. Caterino's institution has received grant funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health and for industry-initiated research from Entegrion and Astra Zeneca. Dr. Caterino has received funding from Wellstat Therapeutics. Dr. Diercks' institution has received grant funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health and contract funding from Novartis , Ortho Scientific, and Roche for industry-initiated research institutional research. Dr. Diercks has received funding from Roche for consulting. Dr. Nishijima's institution has received grant funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health , and Dr. Nishijima has received funding from Pfizer for consulting. Dr. Shah's institution has received grant funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health and contract funding from Roche and Omron for industry-initiated research. Dr. Stiffler's institution has received grant funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health . Dr. Storrow's institution has received grant funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health , and Dr. Storrow has received funding from Siemens and Quidel for consulting. Dr. Wilber's institution has received grant funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health . Dr. Sun has received grant funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health , and Dr. Sun has received funding from Medtronic and received diagnostic testing platforms for this study from Roche . Publisher Copyright: {\textcopyright} 2020 Elsevier Inc.",
year = "2020",
month = aug,
doi = "10.1016/j.jemermed.2020.02.020",
language = "English (US)",
volume = "59",
pages = "193--200",
journal = "Journal of Emergency Medicine",
issn = "0736-4679",
publisher = "Elsevier USA",
number = "2",
}