Derivation of Outcome-Based Pediatric Critical Values

American Journal of Clinical Pathology
Hao DuTze Ping Loh

Abstract

There is currently a lack of an outcomes-based definition of critical values for the pediatric population. This has contributed to a highly heterogeneous critical value reporting practice between laboratories. Anonymized results were extracted from a laboratory information system for 10 biochemistry tests. The probability of high-dependency/intensive care unit admission (as a proxy for adverse outcomes) for each individual laboratory concentration was calculated and adjusted to fit using a polynomial function to model the probability trend. The laboratory value that intersected the 90% probability trend line was considered the critical value threshold. The critical value thresholds for the serum analytes were sodium (mmol/L: <131, >148), potassium (mmol/L: <2.4, >6.4), bicarbonate (mmol/L: <13, >37), chloride (mmol/L: <91, >115), urea (mmol/L: >12), creatinine (μmol/L: >129), glucose (mmol/L: >17.2), total calcium (mmol/L: <1.9), magnesium (mmol/L: <0.6, >1.2), and phosphate (mmol/L: <0.4, >2.6). This study described an approach to derive contemporary pediatric critical value thresholds.

References

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Apr 16, 2015·American Journal of Clinical Pathology·Tze Ping Loh, Michael Patrick Metz

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Citations

Dec 30, 2018·Journal of Clinical Pathology·Zhutian YangTze Ping Loh
May 9, 2019·American Journal of Clinical Pathology·Eng Hooi TanTze Ping Loh
Jan 1, 2020·American Journal of Clinical Pathology·Rui Zhen TanTze Ping Loh
Dec 2, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Murray M PollackJames E Bost
Dec 18, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Bhaven B PatelJohn N Kheir
Dec 4, 2020·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Annika Reintam BlaserMette M Berger
Oct 30, 2021·Frontiers in Digital Health·Siqi LiuMengling Feng

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