Development and validation of a novel computer-aided score to predict the risk of in-hospital mortality for acutely ill medical admissions in two acute hospitals using their first electronically recorded blood test results and vital signs: a cross-sectional study

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dc.contributor.authorFaisal, Muhammad
dc.contributor.authorScally, Andrew
dc.contributor.authorJackson, Natalie
dc.contributor.authorRichardson, Donald
dc.contributor.authorBeatson, Kevin
dc.contributor.authorHowes, Robin
dc.contributor.authorSpeed, Kevin
dc.contributor.authorMenon, Madhav
dc.contributor.authorDaws, Jeremey
dc.contributor.authorDyson, Judith
dc.contributor.authorMarsh, Claire
dc.contributor.authorMohammed, Mohammed A.
dc.contributor.funderNational Institute for Health Researchen
dc.contributor.funderYorkshire and Humberside Patient Safety Translational Research Centreen
dc.contributor.funderHealth Foundationen
dc.date.accessioned2019-06-24T09:07:02Z
dc.date.available2019-06-24T09:07:02Z
dc.date.issued2018-12-06
dc.description.abstractObjectives There are no established mortality risk equations specifically for emergency medical patients who are admitted to a general hospital ward. Such risk equations may be useful in supporting the clinical decision-making process. We aim to develop and externally validate a computer-aided risk of mortality (CARM) score by combining the first electronically recorded vital signs and blood test results for emergency medical admissions.Design Logistic regression model development and external validation study.Setting Two acute hospitals (Northern Lincolnshire and Goole NHS Foundation Trust Hospital (NH)—model development data; York Hospital (YH)—external validation data).Participants Adult (aged ≥16 years) medical admissions discharged over a 24-month period with electronic National Early Warning Score(s) and blood test results recorded on admission.Results The risk of in-hospital mortality following emergency medical admission was 5.7% (NH: 1766/30 996) and 6.5% (YH: 1703/26 247). The C-statistic for the CARM score in NH was 0.87 (95% CI 0.86 to 0.88) and was similar in an external hospital setting YH (0.86, 95% CI 0.85 to 0.87) and the calibration slope included 1 (0.97, 95% CI 0.94 to 1.00).Conclusions We have developed a novel, externally validated CARM score with good performance characteristics for estimating the risk of in-hospital mortality following an emergency medical admission using the patient’s first, electronically recorded, vital signs and blood test results. Since the CARM score places no additional data collection burden on clinicians and is readily automated, it may now be carefully introduced and evaluated in hospitals with sufficient informatics infrastructure.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleide022939en
dc.identifier.citationFaisal, M., Scally, A.J., Jackson, N., Richardson, D., Beatson, K., Howes, R., Speed, K., Menon, M., Daws, J., Dyson, J. and Marsh, C., 2018. Development and validation of a novel computer-aided score to predict the risk of in-hospital mortality for acutely ill medical admissions in two acute hospitals using their first electronically recorded blood test results and vital signs: a cross-sectional study. BMJ open, 8(12): e022939, (8pp.) DOI: 10.1136/bmjopen-2018-022939en
dc.identifier.doi10.1136/bmjopen-2018-022939en
dc.identifier.eissn2044-6055
dc.identifier.endpage8en
dc.identifier.issued12en
dc.identifier.journaltitleBMJ Openen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/8087
dc.identifier.volume8en
dc.language.isoenen
dc.publisherBMJ Publishing Groupen
dc.relation.urihttps://bmjopen.bmj.com/content/8/12/e022939
dc.rights© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.en
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/en
dc.subjectIn-hospital mortalityen
dc.subjectRisk estimationen
dc.subjectElectroniaclly recorded blood testen
dc.titleDevelopment and validation of a novel computer-aided score to predict the risk of in-hospital mortality for acutely ill medical admissions in two acute hospitals using their first electronically recorded blood test results and vital signs: a cross-sectional studyen
dc.typeArticle (peer-reviewed)en
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