Laboratory tests to identify patients at risk of early major adverse events: a prospective pilot study

Melissa Kaufman, B Bebee, James Bailey, Raymond Robbins, Graeme Keith Hart, Rinaldo Bellomo

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4 Citations (Scopus)

Abstract

Background/Aims: To test whether commonly measured laboratory variables can identify surgical patients at risk of major adverse events (death, unplanned intensive care unit (ICU) admission or rapid response team (RRT) activation). Methods: We conducted a prospective observational study in a surgical ward of a university-affiliated hospital in a cohort of 834 surgical patients admitted for >24 h. We applied a previously validated multivariable model-derived risk assessment to each combined set of common laboratory tests to identify patients at risk. We compared the clinical course of such patients with that of control patients from the same ward who had blood tests but were identified as low risk. Results: We studied 7955 batches and 73 428 individual tests in 834 patients (males 55 ; average age 65.8 ? 17.6 years). Among these patients, 66 (7.9 ) were identified as `high risk?. High-risk patients were older (75.9 vs 61.8 years of age; P <0.0001), had much greater early (48 h) mortality (6/66 (9 ) vs 4/768 (0.5 ); P <0.0001) and greater overall hospital mortality (11/66 (16.7 ) vs 9/768 (1.2 ); P <0.0001). They also had more early (8/66 (12.1 ) vs 14/768 (1.8 ); P = 0.0001) and overall in-hospital unplanned ICU admissions (12/66 (18.2 ) vs 18/768 (2.3 ); P <0.0001) and more early (26/66 (39.3 ) vs 50/768 (6.5 ); P <0.0001) and overall in-hospital RRT calls (26/66 (39.4 ) vs 55/768 (7.2 ); P <0.0001). Conclusions: Commonly performed laboratory tests identify surgical ward patients at risk of early major adverse events. Further studies are needed to assess whether such identification
Original languageEnglish
Pages (from-to)1005 - 1012
Number of pages8
JournalInternal Medicine Journal
Volume44
Issue number10
DOIs
Publication statusPublished - 2014

Cite this

Kaufman, Melissa ; Bebee, B ; Bailey, James ; Robbins, Raymond ; Hart, Graeme Keith ; Bellomo, Rinaldo. / Laboratory tests to identify patients at risk of early major adverse events: a prospective pilot study. In: Internal Medicine Journal. 2014 ; Vol. 44, No. 10. pp. 1005 - 1012.
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abstract = "Background/Aims: To test whether commonly measured laboratory variables can identify surgical patients at risk of major adverse events (death, unplanned intensive care unit (ICU) admission or rapid response team (RRT) activation). Methods: We conducted a prospective observational study in a surgical ward of a university-affiliated hospital in a cohort of 834 surgical patients admitted for >24 h. We applied a previously validated multivariable model-derived risk assessment to each combined set of common laboratory tests to identify patients at risk. We compared the clinical course of such patients with that of control patients from the same ward who had blood tests but were identified as low risk. Results: We studied 7955 batches and 73 428 individual tests in 834 patients (males 55 ; average age 65.8 ? 17.6 years). Among these patients, 66 (7.9 ) were identified as `high risk?. High-risk patients were older (75.9 vs 61.8 years of age; P <0.0001), had much greater early (48 h) mortality (6/66 (9 ) vs 4/768 (0.5 ); P <0.0001) and greater overall hospital mortality (11/66 (16.7 ) vs 9/768 (1.2 ); P <0.0001). They also had more early (8/66 (12.1 ) vs 14/768 (1.8 ); P = 0.0001) and overall in-hospital unplanned ICU admissions (12/66 (18.2 ) vs 18/768 (2.3 ); P <0.0001) and more early (26/66 (39.3 ) vs 50/768 (6.5 ); P <0.0001) and overall in-hospital RRT calls (26/66 (39.4 ) vs 55/768 (7.2 ); P <0.0001). Conclusions: Commonly performed laboratory tests identify surgical ward patients at risk of early major adverse events. Further studies are needed to assess whether such identification",
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Laboratory tests to identify patients at risk of early major adverse events: a prospective pilot study. / Kaufman, Melissa; Bebee, B; Bailey, James; Robbins, Raymond; Hart, Graeme Keith; Bellomo, Rinaldo.

In: Internal Medicine Journal, Vol. 44, No. 10, 2014, p. 1005 - 1012.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Laboratory tests to identify patients at risk of early major adverse events: a prospective pilot study

AU - Kaufman, Melissa

AU - Bebee, B

AU - Bailey, James

AU - Robbins, Raymond

AU - Hart, Graeme Keith

AU - Bellomo, Rinaldo

PY - 2014

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N2 - Background/Aims: To test whether commonly measured laboratory variables can identify surgical patients at risk of major adverse events (death, unplanned intensive care unit (ICU) admission or rapid response team (RRT) activation). Methods: We conducted a prospective observational study in a surgical ward of a university-affiliated hospital in a cohort of 834 surgical patients admitted for >24 h. We applied a previously validated multivariable model-derived risk assessment to each combined set of common laboratory tests to identify patients at risk. We compared the clinical course of such patients with that of control patients from the same ward who had blood tests but were identified as low risk. Results: We studied 7955 batches and 73 428 individual tests in 834 patients (males 55 ; average age 65.8 ? 17.6 years). Among these patients, 66 (7.9 ) were identified as `high risk?. High-risk patients were older (75.9 vs 61.8 years of age; P <0.0001), had much greater early (48 h) mortality (6/66 (9 ) vs 4/768 (0.5 ); P <0.0001) and greater overall hospital mortality (11/66 (16.7 ) vs 9/768 (1.2 ); P <0.0001). They also had more early (8/66 (12.1 ) vs 14/768 (1.8 ); P = 0.0001) and overall in-hospital unplanned ICU admissions (12/66 (18.2 ) vs 18/768 (2.3 ); P <0.0001) and more early (26/66 (39.3 ) vs 50/768 (6.5 ); P <0.0001) and overall in-hospital RRT calls (26/66 (39.4 ) vs 55/768 (7.2 ); P <0.0001). Conclusions: Commonly performed laboratory tests identify surgical ward patients at risk of early major adverse events. Further studies are needed to assess whether such identification

AB - Background/Aims: To test whether commonly measured laboratory variables can identify surgical patients at risk of major adverse events (death, unplanned intensive care unit (ICU) admission or rapid response team (RRT) activation). Methods: We conducted a prospective observational study in a surgical ward of a university-affiliated hospital in a cohort of 834 surgical patients admitted for >24 h. We applied a previously validated multivariable model-derived risk assessment to each combined set of common laboratory tests to identify patients at risk. We compared the clinical course of such patients with that of control patients from the same ward who had blood tests but were identified as low risk. Results: We studied 7955 batches and 73 428 individual tests in 834 patients (males 55 ; average age 65.8 ? 17.6 years). Among these patients, 66 (7.9 ) were identified as `high risk?. High-risk patients were older (75.9 vs 61.8 years of age; P <0.0001), had much greater early (48 h) mortality (6/66 (9 ) vs 4/768 (0.5 ); P <0.0001) and greater overall hospital mortality (11/66 (16.7 ) vs 9/768 (1.2 ); P <0.0001). They also had more early (8/66 (12.1 ) vs 14/768 (1.8 ); P = 0.0001) and overall in-hospital unplanned ICU admissions (12/66 (18.2 ) vs 18/768 (2.3 ); P <0.0001) and more early (26/66 (39.3 ) vs 50/768 (6.5 ); P <0.0001) and overall in-hospital RRT calls (26/66 (39.4 ) vs 55/768 (7.2 ); P <0.0001). Conclusions: Commonly performed laboratory tests identify surgical ward patients at risk of early major adverse events. Further studies are needed to assess whether such identification

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