Patient centred variables with univariate associations with unplanned ICU admission: a systematic review

BMC Medical Informatics and Decision Making

Timothy Bonnici¹  Guy Ludbrook²  David A. Clifton³  J. Duncan Young⁴  James Malycha⁴  Peter J. Watkinson⁴ 

[1] 0000 0004 0612 2754, grid.439749.4, Department of Critical Care, University College London Hospitals Foundation Trust, Maple Link Bridge, University College Hospital, 235 Euston Road, NW1 2BU, London, UK;0000 0004 1936 7304, grid.1010.0, Faculty of Health and Medical Science, University of Adelaide, North Terrace, AHMS Floor 8, 5000, Adelaide, Australia;0000 0004 1936 8948, grid.4991.5, Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Old Road Campus, Roosevelt Drive, OX3 7DC, Oxford, UK;Kadoorie Centre for Critical Care Research and Education, Nuffield Department of Clinical Neurosciences, University of Oxford, Level 3, John Radcliffe Hospital, Headley Way, OX3 9DU, Oxford, UK;

关键词: Critical care;    Intensive care;    ICU admission;    Clinical deterioration;    EPR;    EHR;    Variable selection;    Systematic review;    Predictive scores;   

DOI  :  10.1186/s12911-019-0820-1

来源: publisher

【 摘 要 】

BackgroundMultiple predictive scores using Electronic Patient Record data have been developed for hospitalised patients at risk of clinical deterioration. Methods used to select patient centred variables for inclusion in these scores varies. We performed a systematic review to describe univariate associations with unplanned Intensive Care Unit (ICU) admission with the aim of assisting model development for future scores that predict clinical deterioration.MethodsData sources were MEDLINE, EMBASE, CINAHL, CENTRAL and the Cochrane Database of Systematic Reviews. Included studies were published since 2000 describing an association between patient centred variables and unplanned ICU admission determined using univariate analysis. Two authors independently screened titles, abstracts and full texts against inclusion and exclusion criteria. DistillerSR (Evidence Partners, Canada, Ottawa, Ontario) software was used to manage the data and identify duplicate search results. All screening and data extraction forms were implemented within DistillerSR. Study quality was assessed using an adapted version of the Newcastle-Ottawa Scale. Variables were analysed for strength of association with unplanned ICU admission.ResultsThe database search yielded 1520 unique studies; 1462 were removed after title and abstract review; 57 underwent full text screening; 16 studies were included. One hundred and eighty nine variables with an evaluated univariate association with unplanned ICU admission were described.DiscussionBeing male, increasing age, a history of congestive cardiac failure or diabetes, a diagnosis of hepatic disease or having abnormal vital signs were all strongly associated with ICU admission.ConclusionThese findings will assist variable selection during the development of future models predicting unplanned ICU admission.Trial registrationThis study is a component of a larger body of work registered in the ISRCTN registry (ISRCTN12518261).

【 授权许可】

CC BY