Can a summary laboratory score predict health status and inpatient utilization
The Genie score is a summary laboratory score derived from the average of a patient's deviations from specified normal laboratory values. The ability of the Genie score to predict important inpatient resource use, functional status, and patient comorbidity values was studied. Using the Department of Veterans Affairs central hospital administrative file, a random sample of patients who were discharged from the Durham Veterans Affairs Medical Center general medicine service during a five-month study period in 1991 were selected. All necessary laboratory values used to calculate Genie scores were subsequently obtained from computerized files and manual chart audits. The first laboratory result reported from one day before to seven days after the admission date was used to calculate Genie scores. Genie scores calculated at admission show a strong positive correlation with length of stay for that admission (r(s) = 0.42, p < 0.001). The Genie scores were similar, however, for patients with and without a hospital readmission within six months of discharge (15.8 versus 16.7, p = 0.91). In terms of association with patient functional status and medical comorbidity, Genie scores were similar across Karnofsky status quartiles, ranging from 15.2-17.3 (p = 0.88). A higher overall Genie score, however, was associated with higher values on all comorbidity indices (Smith, Charlson, Index of Coexistent Disease), except the Kaplan and Feinstein scale. Summary scores based upon objective, easily obtained data which can be calculated early in the hospitalization have great potential for clinicians, policy makers, and researchers.
