Ability of Video Telemetry to Predict Unplanned Hospital Admissions for Single Ventricle Infants
Background Our Cardiac High Acuity Monitoring Program (CHAMP) uses home video telemetry (HVT) as an adjunct to monitor infants with single ventricle during the interstage period. This study describes the development of an objective early warning score using HVT, for identification of infants with si...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.020851 |
| _version_ | 1797810160931962880 |
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| author | Doaa M. Aly Lori A. Erickson Hayley Hancock Jonathan W. Apperson Monica Gaddis Girish Shirali Suma Goudar |
| author_facet | Doaa M. Aly Lori A. Erickson Hayley Hancock Jonathan W. Apperson Monica Gaddis Girish Shirali Suma Goudar |
| author_sort | Doaa M. Aly |
| collection | DOAJ |
| description | Background Our Cardiac High Acuity Monitoring Program (CHAMP) uses home video telemetry (HVT) as an adjunct to monitor infants with single ventricle during the interstage period. This study describes the development of an objective early warning score using HVT, for identification of infants with single ventricle at risk for clinical deterioration and unplanned hospital admissions (UHA). Methods and Results Six candidate scoring parameters were selected to develop a pragmatic score for routine evaluation of HVT during the interstage period. We evaluated the individual and combined ability of these parameters to predict UHA. All infants with single ventricle monitored at home by CHAMP between March 2014 and March 2018 were included. Videos obtained within 48 hours before UHA were compared with videos obtained at baseline. We used binary logistic regression models and receiver operating characteristic curves to evaluate the parameters' performance in discriminating the outcome of interest. Thirty‐nine subjects with 64 UHA were included. We compared 64 pre‐admission videos to 64 paired baseline videos. Scoring was feasible for a mean of 91.6% (83.6%–98%) of all observations. Three different HVT score models were proposed, and a final model composed of respiratory rate, respiratory effort, color, and behavior exhibited an excellent discriminatory capability with an area under the receiver operating characteristic curve of 93% (89%–98%). HVT score of 5 was associated with specificity of 93.8% and sensitivity of 88.7% in predicting UHA. Conclusions We developed a feasible and reproducible HVT score that can serve as a tool to predict UHA in infants with single ventricle. Future directions involve prospective, multicenter validation of this tool. |
| first_indexed | 2024-03-13T07:05:05Z |
| format | Article |
| id | doaj.art-0dc8a1ce9a7a4d0d93bfd509f6bc9812 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-13T07:05:05Z |
| publishDate | 2021-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-0dc8a1ce9a7a4d0d93bfd509f6bc98122023-06-06T12:10:51ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-08-01101610.1161/JAHA.121.020851Ability of Video Telemetry to Predict Unplanned Hospital Admissions for Single Ventricle InfantsDoaa M. Aly0Lori A. Erickson1Hayley Hancock2Jonathan W. Apperson3Monica Gaddis4Girish Shirali5Suma Goudar6Ward Family Heart Center Children’s Mercy Hospital Kansas City MOWard Family Heart Center Children’s Mercy Hospital Kansas City MOWard Family Heart Center Children’s Mercy Hospital Kansas City MOWard Family Heart Center Children’s Mercy Hospital Kansas City MODepartment of Biomedical and Health Informatics UMKC School of Medicine Kansas City MOWard Family Heart Center Children’s Mercy Hospital Kansas City MOChildren’s National Heart Institute Washington DCBackground Our Cardiac High Acuity Monitoring Program (CHAMP) uses home video telemetry (HVT) as an adjunct to monitor infants with single ventricle during the interstage period. This study describes the development of an objective early warning score using HVT, for identification of infants with single ventricle at risk for clinical deterioration and unplanned hospital admissions (UHA). Methods and Results Six candidate scoring parameters were selected to develop a pragmatic score for routine evaluation of HVT during the interstage period. We evaluated the individual and combined ability of these parameters to predict UHA. All infants with single ventricle monitored at home by CHAMP between March 2014 and March 2018 were included. Videos obtained within 48 hours before UHA were compared with videos obtained at baseline. We used binary logistic regression models and receiver operating characteristic curves to evaluate the parameters' performance in discriminating the outcome of interest. Thirty‐nine subjects with 64 UHA were included. We compared 64 pre‐admission videos to 64 paired baseline videos. Scoring was feasible for a mean of 91.6% (83.6%–98%) of all observations. Three different HVT score models were proposed, and a final model composed of respiratory rate, respiratory effort, color, and behavior exhibited an excellent discriminatory capability with an area under the receiver operating characteristic curve of 93% (89%–98%). HVT score of 5 was associated with specificity of 93.8% and sensitivity of 88.7% in predicting UHA. Conclusions We developed a feasible and reproducible HVT score that can serve as a tool to predict UHA in infants with single ventricle. Future directions involve prospective, multicenter validation of this tool.https://www.ahajournals.org/doi/10.1161/JAHA.121.020851early warning scoreinterstagemonitoringsingle ventricletelemedicineuniventricular heart |
| spellingShingle | Doaa M. Aly Lori A. Erickson Hayley Hancock Jonathan W. Apperson Monica Gaddis Girish Shirali Suma Goudar Ability of Video Telemetry to Predict Unplanned Hospital Admissions for Single Ventricle Infants Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease early warning score interstage monitoring single ventricle telemedicine univentricular heart |
| title | Ability of Video Telemetry to Predict Unplanned Hospital Admissions for Single Ventricle Infants |
| title_full | Ability of Video Telemetry to Predict Unplanned Hospital Admissions for Single Ventricle Infants |
| title_fullStr | Ability of Video Telemetry to Predict Unplanned Hospital Admissions for Single Ventricle Infants |
| title_full_unstemmed | Ability of Video Telemetry to Predict Unplanned Hospital Admissions for Single Ventricle Infants |
| title_short | Ability of Video Telemetry to Predict Unplanned Hospital Admissions for Single Ventricle Infants |
| title_sort | ability of video telemetry to predict unplanned hospital admissions for single ventricle infants |
| topic | early warning score interstage monitoring single ventricle telemedicine univentricular heart |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.020851 |
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