Early Detection of In-Patient Deterioration: One Prediction Model Does Not Fit All

Critical Care Explorations
Jacob N BlackwellJ. Randall Moorman

Abstract

Early detection of subacute potentially catastrophic illnesses using available data is a clinical imperative, and scores that report risk of imminent events in real time abound. Patients deteriorate for a variety of reasons, and it is unlikely that a single predictor such as an abnormal National Early Warning Score will detect all of them equally well. The objective of this study was to test the idea that the diversity of reasons for clinical deterioration leading to ICU transfer mandates multiple targeted predictive models. Individual chart review to determine the clinical reason for ICU transfer; determination of relative risks of individual vital signs, laboratory tests and cardiorespiratory monitoring measures for prediction of each clinical reason for ICU transfer; and logistic regression modeling for the outcome of ICU transfer for a specific clinical reason. Cardiac medical-surgical ward; tertiary care academic hospital. Eight-thousand one-hundred eleven adult patients, 457 of whom were transferred to an ICU for clinical deterioration. None. We calculated the contributing relative risks of individual vital signs, laboratory tests and cardiorespiratory monitoring measures for prediction of each clinical reason for ICU tra...Continue Reading

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Citations

Dec 29, 2020·Critical Care Explorations·John P DavisJ Randall Moorman
Jan 12, 2021·International Journal of Nursing Studies Advances·Jessica Keim-Malpass, Liza P Moorman
Jul 9, 2021·Anesthesiology·Frederic Michard, Cor J Kalkman
Jul 2, 2021·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Roel V PeelenSebastian Jh Bredie
Sep 24, 2021·Applied Clinical Informatics·Liza Prudente Moorman

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