Common laboratory tests predict imminent death in ward patients

Elsa Loekito, James Bailey, Rinaldo Bellomo, Graeme Keith Hart, Colin Hegarty, Peter Davey, Christopher A Bain, David V Pilcher, Hans Schneider

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: To estimate the ability of commonly measured laboratory variables to predict an imminent (within the same or next calendar day) death in ward patients. Design: Retrospective observational study. Setting: Two university affiliated hospitals. Patients: Cohort of 42,701 patients admitted for more than 24 hours and external validation cohort of 13,137 patients admitted for more than 24 hours. Intervention: We linked commonly measured laboratory tests with event databases and assessed the ability of each laboratory variable or combination of variables together with patient age to predict imminent death. Measurements and main results: In the inception teaching hospital, we studied 418,897 batches of tests in 42,701 patients (males 55 ; average age 65.8 ? 17.6 years), for a total of >2.5 million individual measurements. Among these patients, there were 1596 deaths. Multivariable logistic modelling achieved an AUC-ROC of 0.87 (95 CI: 0.85-0.89) for the prediction of imminent death. Using an additional 105,074 batches from a cohort of 13,137 patients from a second teaching hospital, the multivariate model achieved an AUC-ROC of 0.88 (95 CI: 0.85-0.90). Conclusions: Commonly performed laboratory tests can help predict imminent death in ward patients. Prospective investigations of the clinical utility of such predictions appear justified.
Original languageEnglish
Pages (from-to)280 - 285
Number of pages6
JournalResuscitation
Volume84
Issue number3
DOIs
Publication statusPublished - 2013

Cite this

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title = "Common laboratory tests predict imminent death in ward patients",
abstract = "Objective: To estimate the ability of commonly measured laboratory variables to predict an imminent (within the same or next calendar day) death in ward patients. Design: Retrospective observational study. Setting: Two university affiliated hospitals. Patients: Cohort of 42,701 patients admitted for more than 24 hours and external validation cohort of 13,137 patients admitted for more than 24 hours. Intervention: We linked commonly measured laboratory tests with event databases and assessed the ability of each laboratory variable or combination of variables together with patient age to predict imminent death. Measurements and main results: In the inception teaching hospital, we studied 418,897 batches of tests in 42,701 patients (males 55 ; average age 65.8 ? 17.6 years), for a total of >2.5 million individual measurements. Among these patients, there were 1596 deaths. Multivariable logistic modelling achieved an AUC-ROC of 0.87 (95 CI: 0.85-0.89) for the prediction of imminent death. Using an additional 105,074 batches from a cohort of 13,137 patients from a second teaching hospital, the multivariate model achieved an AUC-ROC of 0.88 (95 CI: 0.85-0.90). Conclusions: Commonly performed laboratory tests can help predict imminent death in ward patients. Prospective investigations of the clinical utility of such predictions appear justified.",
author = "Elsa Loekito and James Bailey and Rinaldo Bellomo and Hart, {Graeme Keith} and Colin Hegarty and Peter Davey and Bain, {Christopher A} and Pilcher, {David V} and Hans Schneider",
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pages = "280 -- 285",
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Common laboratory tests predict imminent death in ward patients. / Loekito, Elsa; Bailey, James; Bellomo, Rinaldo; Hart, Graeme Keith; Hegarty, Colin; Davey, Peter; Bain, Christopher A; Pilcher, David V; Schneider, Hans.

In: Resuscitation, Vol. 84, No. 3, 2013, p. 280 - 285.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Loekito, Elsa

AU - Bailey, James

AU - Bellomo, Rinaldo

AU - Hart, Graeme Keith

AU - Hegarty, Colin

AU - Davey, Peter

AU - Bain, Christopher A

AU - Pilcher, David V

AU - Schneider, Hans

PY - 2013

Y1 - 2013

N2 - Objective: To estimate the ability of commonly measured laboratory variables to predict an imminent (within the same or next calendar day) death in ward patients. Design: Retrospective observational study. Setting: Two university affiliated hospitals. Patients: Cohort of 42,701 patients admitted for more than 24 hours and external validation cohort of 13,137 patients admitted for more than 24 hours. Intervention: We linked commonly measured laboratory tests with event databases and assessed the ability of each laboratory variable or combination of variables together with patient age to predict imminent death. Measurements and main results: In the inception teaching hospital, we studied 418,897 batches of tests in 42,701 patients (males 55 ; average age 65.8 ? 17.6 years), for a total of >2.5 million individual measurements. Among these patients, there were 1596 deaths. Multivariable logistic modelling achieved an AUC-ROC of 0.87 (95 CI: 0.85-0.89) for the prediction of imminent death. Using an additional 105,074 batches from a cohort of 13,137 patients from a second teaching hospital, the multivariate model achieved an AUC-ROC of 0.88 (95 CI: 0.85-0.90). Conclusions: Commonly performed laboratory tests can help predict imminent death in ward patients. Prospective investigations of the clinical utility of such predictions appear justified.

AB - Objective: To estimate the ability of commonly measured laboratory variables to predict an imminent (within the same or next calendar day) death in ward patients. Design: Retrospective observational study. Setting: Two university affiliated hospitals. Patients: Cohort of 42,701 patients admitted for more than 24 hours and external validation cohort of 13,137 patients admitted for more than 24 hours. Intervention: We linked commonly measured laboratory tests with event databases and assessed the ability of each laboratory variable or combination of variables together with patient age to predict imminent death. Measurements and main results: In the inception teaching hospital, we studied 418,897 batches of tests in 42,701 patients (males 55 ; average age 65.8 ? 17.6 years), for a total of >2.5 million individual measurements. Among these patients, there were 1596 deaths. Multivariable logistic modelling achieved an AUC-ROC of 0.87 (95 CI: 0.85-0.89) for the prediction of imminent death. Using an additional 105,074 batches from a cohort of 13,137 patients from a second teaching hospital, the multivariate model achieved an AUC-ROC of 0.88 (95 CI: 0.85-0.90). Conclusions: Commonly performed laboratory tests can help predict imminent death in ward patients. Prospective investigations of the clinical utility of such predictions appear justified.

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