Laboratory risk factors for hospital mortality.

Sir, The work by Asadollahi et al. 1 is interesting, but far from novel. They state that there has been little robust research into early predictive factors of hospital mortality. However, they fail to acknowledge the considerable body of work already addressing this problem, much of which incorporates laboratory data to some extent. 2–10 They also suggest that risk assessment on the basis of laboratory investigations has been concentrated on specific diagnostic categories or high-risk groups of patients, and that there are no specific mortality prediction systems for general acute admissions. 1 In addition, they claim that the findings of their research raise the possibility of developing a laboratory-based predictive scoring system to estimate risk of hospital mortality. It is surprising that Asadollahi's literature search did not identify any of the above papers, 2–10 but specifically a prospective study published in 2005. 10 This paper presented results for nearly 10 000 unselected medical admissions, was not limited to specific diagnostic categories or risk groups, and offered a suitable algorithm for calculating risk of in-hospital death. 10 The study identified that the risk of hospital death could be predicted using routinely available data very early on after hospital admission, and raised the possibility that the surveillance and treatment of patients might be categorized by risk assessment means. References 1. Asadollahi K, Hastings IM, Beeching NJ, Gill GV. Laboratory risk factors for hospital mortality in acutely admitted patients. Differences in mortality on the basis of complete blood count in an unselected population at the emergency department. et al. Identifying the sick: can biochemical measurements be used to aid decision making on presentation to the accident and emergency department. of Veterans Affairs' NSQIP: the first national, validated, outcome-based, risk-adjusted, and peer-controlled program for the measurement and enhancement of the quality of surgical care.