Objectives: Evaluate the accuracy of different ICU risk models repurposed as continuous markers of severity of illness. Design: Nonintervention cohort study. Setting: eICU Research Institute ICUs using tele-ICU software calculating continuous ICU Discharge Readiness Scores between January 2013 and March 2016. Patients: Five hundred sixty-one thousand four hundred seventy-eight adult ICU patients with an ICU length of stay between 4 hours and 30 days. Interventions: Not available. Measurements and Main Results: Hourly Acute Physiology and Chronic Health Evaluation IV, Sequential Organ Failure Assessment, and Discharge Readiness Scores were calculated beginning hour 4 of the ICU stay. Primary outcome was the area under the receiver operating characteristic curve for the mean score with ICU mortality. Secondary outcomes included area under the receiver operating characteristic curves for ICU mortality with admission, median, maximum and last scores, and for death within 24 hours. The trajectories of each score were visualized by plotting the hourly averages against time in the ICU, stratified by mortality and length of stay. The area under the receiver operating characteristic curves for mean Acute Physiology and Chronic Health Evaluation, Sequential Organ Failure Assessment, and Discharge Readiness Scores were 0.90 (0.89–0.90), 0.86 (0.86–0.86), and 0.94 (0.94–0.94), respectively. The area under the receiver operating characteristic curves for hourly Acute Physiology and Chronic Health Evaluation, Sequential Organ Failure Assessment, and Discharge Readiness Scores predicting 24-hour mortality were 0.81 (0.81–0.81), 0.76 (0.76–0.76), and 0.86 (0.86–0.86). Discharge Readiness Scores had a higher area under the receiver operating characteristic curve than both Acute Physiology and Chronic Health Evaluation and Sequential Organ Failure Assessment for each metric. Acute Physiology and Chronic Health Evaluation and Sequential Organ Failure Assessment scores increased throughout the first 24 hours in both survivors and nonsurvivors; Discharge Readiness Scores continuously decreased in survivors and temporarily decreased before increasing by hour 36 in nonsurvivors with longer length of stays. Conclusions: Acute Physiology and Chronic Health Evaluation, Sequential Organ Failure Assessment, and Discharge Readiness Scores all have relatively high discrimination for ICU mortality when used continuously; Discharge Readiness Scores tended to have slightly higher area under the receiver operating characteristic curves for each endpoint. These findings validate the use of these models on a population level for continuous risk adjustment in the ICU, although Acute Physiology and Chronic Health Evaluation and Sequential Organ Failure Assessment appear slower to respond to improvements in patient status than Discharge Readiness Scores, and Discharge Readiness Scores may reflect physiologic improvement from interventions, potentially underestimating risk.
http://ift.tt/2GDN38K
Αρχειοθήκη ιστολογίου
-
►
2023
(138)
- ► Φεβρουαρίου (74)
- ► Ιανουαρίου (64)
-
►
2022
(849)
- ► Δεκεμβρίου (61)
- ► Σεπτεμβρίου (74)
- ► Φεβρουαρίου (65)
-
►
2021
(2936)
- ► Δεκεμβρίου (59)
- ► Σεπτεμβρίου (180)
- ► Φεβρουαρίου (325)
-
►
2020
(1624)
- ► Δεκεμβρίου (293)
- ► Σεπτεμβρίου (234)
- ► Φεβρουαρίου (28)
-
►
2019
(13362)
- ► Δεκεμβρίου (19)
- ► Σεπτεμβρίου (54)
- ► Φεβρουαρίου (5586)
- ► Ιανουαρίου (5696)
-
▼
2018
(66471)
- ► Δεκεμβρίου (5242)
- ► Σεπτεμβρίου (5478)
-
▼
Φεβρουαρίου
(4835)
-
▼
Φεβ 23
(184)
- New-onset refractory status epilepticus (NORSE) an...
- Inspissated cyst fluid in endoscopic ultrasound-gu...
- Clinical performance of endobronchial ultrasound-g...
- The Australian Managed Entry Scheme: Are We Gettin...
- Diagnosis of arterial gas embolism in SCUBA diving...
- Neuronal apoptosis in the brainstem medulla of sud...
- “Defense” type wounds in suicide
- Internal patterned injuries in trauma
- Double-chambered left ventricle – a “heart within ...
- Rapid and reliable detection of previous freezing ...
- Pandora’s box
- A homemade furnace. Influence of occupational skil...
- The autopsy and diagnosis of pulmonary thrombo-emb...
- Postmortem radiological case series of acetabular ...
- Pioglitazone and bladder cancer risk: a systematic...
- Correction to: Olaratumab in Combination with Doxo...
- A rare case of right pulmonary segmental artery di...
- Severe hypophosphataemia: a rare cause of postoper...
- Role Of Conservative Management In Emphysematous G...
- Portomesenteric vein thrombosis following laparosc...
- First case of acute granulomatous interstitial nep...
- Nail to the heart: no big deal. A rare case of pos...
- Recurrent postinfectious glomerulonephritis: an un...
- Stimming behaviour in a 4-year-old girl with autis...
- Postoperative epidural abscess after spinal anaest...
- Incidental presentation of a button battery within...
- Attenuated form of type II mucopolysaccharidoses (...
- Nivolumab in the treatment of microsatellite insta...
- Dose-response and efficacy of spinal manipulation ...
- Biomechanical evaluation of sacroiliac joint fixat...
- Bariatric surgery before elective posterior lumbar...
- Genomic-Enabled Prediction Kernel Models with Rand...
- Targeted Long-Read Sequencing of a Locus Under Lon...
- Neural Representations Observed
- Introducing a New Series: Immunotherapy Facts and ...
- FDA Approval: Gemtuzumab ozogamicin for the treatm...
- Updated Results of Rituximab Pre- and Post-BEAM wi...
- Administration of Hypoxia-Activated Prodrug Evofos...
- Vitamin D-Binding Protein Enhances Epithelial Ovar...
- Focal Irradiation And Systemic Transforming Growth...
- MEK Binding to KSR Promotes Allosteric Activation ...
- TGF{beta} Promotes Immune Evasion to Limit the Eff...
- The Oncolytic Adenovirus DNX-2401 Has Antitumor Ac...
- Startups Bring AI to Pathology [News in Brief]
- The Effects of Vitamin D Supplementation on Biomar...
- Uro-oncology 2018: new horizons, new treatment opt...
- Targeting angiogenesis in lung cancer
- Antiangiogenic therapies in ovarian cancer
- Our differences make us stronger
- Histone deacetylase inhibitors protect against cis...
- Plasma exosomes induced by remote ischaemic precon...
- Kupffer cell-derived TNF-α promotes hepatocytes to...
- Laser evoked potential amplitude and laser-pain ra...
- Pain-motor Integration and Chronic Pain: One Step ...
- Labetalol Hydrochloride Injection by Hospira: Reca...
- Intracholecystic papillary neoplasm of the gallbla...
- Combining Biologics in Inflammatory Bowel Disease ...
- Real-world Safety and Efficacy of Fluid-filled Dua...
- Management of Traditional Cardiovascular Risk Fact...
- Physical Activity in Kidney Transplant Recipients:...
- Management of Heart Failure in Advancing CKD: Core...
- How Omics Data Can Be Used in Nephrology
- Labetalol Hydrochloride Injection by Hospira: Reca...
- New Research From Psychological Science
- Dengue periodic outbreaks and epidemiological tren...
- Duration of acute kidney injury in critically ill ...
- Simulating the Mechanics of Lens Accommodation via...
- Can P-glycoprotein and β-tubulin polymorphisms be ...
- Lens-free Video Microscopy for the Dynamic and Qua...
- On-Site Molecular Detection of Soil-Borne Phytopat...
- Bedside Detection of Overassistance During Pressur...
- The authors reply
- Continuous Infusion of Low-Dose Iohexol Measures C...
- Kinetics of Urinary Cell Cycle Arrest Markers for ...
- Optimal Cerebral Perfusion Pressure in Centers Wit...
- Temporal Trends in Incidence, Sepsis-Related Morta...
- Evaluation of ICU Risk Models Adapted for Use as C...
- Validation of a Novel Molecular Host Response Assa...
- Effects of Propofol on Cellular Bioenergetics in H...
- Update of a Systematic Review of Autoresuscitation...
- Initial Antifungal Strategy Reduces Mortality in C...
- The Association of ICU Acuity With Outcomes of Pat...
- Severity of Illness Scores May Misclassify Critica...
- Risk Factors of Impaired Neuropsychologic Outcome ...
- Platelet Drop and Fibrinolytic Shutdown in Patient...
- Accuracy of Invasive and Noninvasive Parameters fo...
- Endothelial Cell-Specific Molecule-1 in Critically...
- Rare Events in the ICU: An Emerging Challenge in C...
- The authors reply
- Ventilator-Free Day Outcomes Can Be Misleading
- NK-cell enteropathy: a case report with ten years ...
- iSepsis – Sepsis 3.0- Flogging a dead horse!
- A Selection of Abstracts Presented at the 44th Ann...
- A Method for Determination and Simulation of Perme...
- A Method to Assess Fc-mediated Effector Functions ...
- Impact of pulsed xenon ultraviolet disinfection on...
- Seroprevalence of dengue IgG antibodies in symptom...
- Systemic fluoroquinolone prescriptions for hospita...
- Dengue score as a diagnostic predictor for pleural...
- Alcohol dysregulates miR-148a in hepatocytes throu...
-
▼
Φεβ 23
(184)
- ► Ιανουαρίου (5592)
-
►
2017
(44259)
- ► Δεκεμβρίου (5110)
- ► Σεπτεμβρίου (5105)
-
►
2016
(7467)
- ► Δεκεμβρίου (514)
- ► Σεπτεμβρίου (1038)
- ► Φεβρουαρίου (793)
Αναζήτηση αυτού του ιστολογίου
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
-
Αλέξανδρος Γ. Σφακιανάκης Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,0030693260717...
-
heory of COVID-19 pathogenesis Publication date: November 2020Source: Medical Hypotheses, Volume 144Author(s): Yuichiro J. Suzuki ScienceD...
-
https://ift.tt/2MQ8Ai8
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου
Σημείωση: Μόνο ένα μέλος αυτού του ιστολογίου μπορεί να αναρτήσει σχόλιο.