1 research outputs found
Development of Computable Phenotype to Identify and Characterize Transitions in Acuity Status in Intensive Care Unit
Background: In the United States, 5.7 million patients are admitted annually
to intensive care units (ICU), with costs exceeding $82 billion. Although close
monitoring and dynamic assessment of patient acuity are key aspects of ICU
care, both are limited by the time constraints imposed on healthcare providers.
Methods: Using the University of Florida Health (UFH) Integrated Data
Repository as Honest Broker, we created a database with electronic health
records data from a retrospective study cohort of 38,749 adult patients
admitted to ICU at UF Health between 06/01/2014 and 08/22/2019. This repository
includes demographic information, comorbidities, vital signs, laboratory
values, medications with date and timestamps, and diagnoses and procedure codes
for all index admission encounters as well as encounters within 12 months prior
to index admission and 12 months follow-up. We developed algorithms to identify
acuity status of the patient every four hours during each ICU stay. Results: We
had 383,193 encounters (121,800 unique patients) admitted to the hospital, and
51,073 encounters (38,749 unique patients) with at least one ICU stay that
lasted more than four hours. These patients requiring ICU admission had longer
median hospital stay (7 days vs. 1 day) and higher in-hospital mortality (9.6%
vs. 0.4%) compared with those not admitted to the ICU. Among patients who were
admitted to the ICU and expired during hospital admission, more deaths occurred
in the ICU than on general hospital wards (7.4% vs. 0.8%, respectively).
Conclusions: We developed phenotyping algorithms that determined patient acuity
status every four hours while admitted to the ICU. This approach may be useful
in developing prognostic and clinical decision-support tools to aid patients,
caregivers, and providers in shared decision-making processes regarding
resource use and escalation of care.Comment: 21 Pages, that include 6 figures, 3 tables and 1 supplemental Tabl