Predicting in-hospital mortality and unanticipated admissions to the intensive care unit using routinely collected blood tests and vital signs: Development and validation of a multivariable model
Authors: Redfern, O.C., Pimentel, M.A.F., Prytherch, D., Meredith, P., Clifton, D.A., Tarassenko, L., Smith, G.B. and Watkinson, P.J.
Journal: Resuscitation
Volume: 133
Pages: 75-81
eISSN: 1873-1570
ISSN: 0300-9572
DOI: 10.1016/j.resuscitation.2018.09.021
Abstract:Aim: The National Early Warning System (NEWS) is based on vital signs; the Laboratory Decision Tree Early Warning Score (LDT-EWS) on laboratory test results. We aimed to develop and validate a new EWS (the LDTEWS:NEWS risk index) by combining the two and evaluating the discrimination of the primary outcome of unanticipated intensive care unit (ICU) admission or in-hospital mortality, within 24 h. Methods: We studied emergency medical admissions, aged 16 years or over, admitted to Oxford University Hospitals (OUH) and Portsmouth Hospitals (PH). Each admission had vital signs and laboratory tests measured within their hospital stay. We combined LDT-EWS and NEWS values using a linear time-decay weighting function imposed on the most recent blood tests. The LDTEWS:NEWS risk index was developed using data from 5 years of admissions to PH, and validated on a year of data from both PH and OUH. We tested the risk index's ability to discriminate the primary outcome using the c-statistic. Results: The development cohort contained 97,933 admissions (median age = 73 years) of which 4723 (4.8%) resulted inhospital death and 1078 (1.1%) in unanticipated ICU admission. We validated the risk index using data from PH (n = 21,028) and OUH (n = 16,383). The risk index showed a higher discrimination in the validation sets (c-statistic value (95% CI)) (PH, 0.901 (0.898–0.905); OUH, 0.916 (0.911–0.921)), than NEWS alone (PH, 0.877 (0.873–0.882); OUH, 0.898 (0.893–0.904)). Conclusions: The LDTEWS:NEWS risk index increases the ability to identify patients at risk of deterioration, compared to NEWS alone.
https://eprints.bournemouth.ac.uk/31400/
Source: Scopus
Predicting in-hospital mortality and unanticipated admissions to the intensive care unit using routinely collected blood tests and vital signs: Development and validation of a multivariable model.
Authors: Redfern, O.C., Pimentel, M.A.F., Prytherch, D., Meredith, P., Clifton, D.A., Tarassenko, L., Smith, G.B. and Watkinson, P.J.
Journal: Resuscitation
Volume: 133
Pages: 75-81
eISSN: 1873-1570
DOI: 10.1016/j.resuscitation.2018.09.021
Abstract:AIM: The National Early Warning System (NEWS) is based on vital signs; the Laboratory Decision Tree Early Warning Score (LDT-EWS) on laboratory test results. We aimed to develop and validate a new EWS (the LDTEWS:NEWS risk index) by combining the two and evaluating the discrimination of the primary outcome of unanticipated intensive care unit (ICU) admission or in-hospital mortality, within 24 h. METHODS: We studied emergency medical admissions, aged 16 years or over, admitted to Oxford University Hospitals (OUH) and Portsmouth Hospitals (PH). Each admission had vital signs and laboratory tests measured within their hospital stay. We combined LDT-EWS and NEWS values using a linear time-decay weighting function imposed on the most recent blood tests. The LDTEWS:NEWS risk index was developed using data from 5 years of admissions to PH, and validated on a year of data from both PH and OUH. We tested the risk index's ability to discriminate the primary outcome using the c-statistic. RESULTS: The development cohort contained 97,933 admissions (median age = 73 years) of which 4723 (4.8%) resulted inhospital death and 1078 (1.1%) in unanticipated ICU admission. We validated the risk index using data from PH (n = 21,028) and OUH (n = 16,383). The risk index showed a higher discrimination in the validation sets (c-statistic value (95% CI)) (PH, 0.901 (0.898-0.905); OUH, 0.916 (0.911-0.921)), than NEWS alone (PH, 0.877 (0.873-0.882); OUH, 0.898 (0.893-0.904)). CONCLUSIONS: The LDTEWS:NEWS risk index increases the ability to identify patients at risk of deterioration, compared to NEWS alone.
https://eprints.bournemouth.ac.uk/31400/
Source: PubMed
Predicting in-hospital mortality and unanticipated admissions to the intensive care unit using routinely collected blood tests and vital signs: Development and validation of a multivariable model
Authors: Redfern, O.C., Pimentel, M.A.F., Prytherch, D., Meredith, P., Clifton, D.A., Tarassenko, L., Smith, G.B. and Watkinson, P.J.
Journal: RESUSCITATION
Volume: 133
Pages: 75-81
ISSN: 0300-9572
DOI: 10.1016/j.resuscitation.2018.09.021
https://eprints.bournemouth.ac.uk/31400/
Source: Web of Science (Lite)
Predicting in-hospital mortality and unanticipated admissions to the intensive care unit using routinely collected blood tests and vital signs: Development and validation of a multivariable model.
Authors: Redfern, O.C., Pimentel, M.A.F., Prytherch, D., Meredith, P., Clifton, D.A., Tarassenko, L., Smith, G.B. and Watkinson, P.J.
Journal: Resuscitation
Volume: 133
Pages: 75-81
eISSN: 1873-1570
ISSN: 0300-9572
DOI: 10.1016/j.resuscitation.2018.09.021
Abstract:Aim
The National Early Warning System (NEWS) is based on vital signs; the Laboratory Decision Tree Early Warning Score (LDT-EWS) on laboratory test results. We aimed to develop and validate a new EWS (the LDTEWS:NEWS risk index) by combining the two and evaluating the discrimination of the primary outcome of unanticipated intensive care unit (ICU) admission or in-hospital mortality, within 24 h.Methods
We studied emergency medical admissions, aged 16 years or over, admitted to Oxford University Hospitals (OUH) and Portsmouth Hospitals (PH). Each admission had vital signs and laboratory tests measured within their hospital stay. We combined LDT-EWS and NEWS values using a linear time-decay weighting function imposed on the most recent blood tests. The LDTEWS:NEWS risk index was developed using data from 5 years of admissions to PH, and validated on a year of data from both PH and OUH. We tested the risk index's ability to discriminate the primary outcome using the c-statistic.Results
The development cohort contained 97,933 admissions (median age = 73 years) of which 4723 (4.8%) resulted inhospital death and 1078 (1.1%) in unanticipated ICU admission. We validated the risk index using data from PH (n = 21,028) and OUH (n = 16,383). The risk index showed a higher discrimination in the validation sets (c-statistic value (95% CI)) (PH, 0.901 (0.898-0.905); OUH, 0.916 (0.911-0.921)), than NEWS alone (PH, 0.877 (0.873-0.882); OUH, 0.898 (0.893-0.904)).Conclusions
The LDTEWS:NEWS risk index increases the ability to identify patients at risk of deterioration, compared to NEWS alone.https://eprints.bournemouth.ac.uk/31400/
Source: Europe PubMed Central
Predicting in-hospital mortality and unanticipated admissions to the intensive care unit using routinely collected blood tests and vital signs: development and validation of a multivariable model.
Authors: Redfern, O., Pimentel, M.A.F., Prytherch, D., Meredith, P., Clifton, D.A., Tarassenko, L., Smith, G.B. and Watkinson, P.J.
Journal: Resuscitation
Volume: 133
Issue: December
Pages: 75-81
ISSN: 0300-9572
Abstract:AIM: The National Early Warning System (NEWS) is based on vital signs; the Laboratory Decision Tree Early Warning Score (LDT-EWS) on laboratory test results. We aimed to develop and validate a new EWS (the LDTEWS:NEWS risk index) by combining the two and evaluating the discrimination of the primary outcome of unanticipated intensive care unit (ICU) admission or in-hospital mortality, within 24 hours. METHODS: We studied emergency medical admissions, aged 16 years or over, admitted to Oxford University Hospitals (OUH) and Portsmouth Hospitals (PH). Each admission had vital signs and laboratory tests measured within their hospital stay. We combined LDT-EWS and NEWS values using a linear time-decay weighting function imposed on the most recent blood tests. The LDTEWS:NEWS risk index was developed using data from 5 years of admissions to PH, and validated on a year of data from both PH and OUH. We tested the risk index's ability to discriminate the primary outcome using the c-statistic. RESULTS: The development cohort contained 97,933 admissions (median age = 73 years) of which 4,723 (4.8%) resulted in in-hospital death and 1,078 (1.1%) in unanticipated ICU admission. We validated the risk index using data from PH (n = 21,028) and OUH (n = 16,383). The risk index showed a higher discrimination in the validation sets (c-statistic value (95% CI)) (PH, 0.901 (0.898-0.905); OUH, 0.916 (0.911-0.921)), than NEWS alone (PH, 0.877 (0.873-0.882); OUH, 0.898 (0.893-0.904)). CONCLUSIONS: The LDTEWS:NEWS risk index increases the ability to identify patients at risk of deterioration, compared to NEWS alone.
https://eprints.bournemouth.ac.uk/31400/
Source: BURO EPrints