Impact of dynamic parameter of trends in vital signs on the prediction of serious events in hospitalized patients -a retrospective observational study
Aim: Although early detection of patients’ deterioration may improve outcomes, most of the detection criteria use on-the-spot values of vital signs. We investigated whether adding trend values over time enhanced the ability to predict adverse events among hospitalized patients. Methods: Patients who...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-06-01
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| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520424000791 |
| _version_ | 1797214838014869504 |
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| author | Rimi Tanii Kuniyoshi Hayashi Takaki Naito Zoie Shui-Yee Wong Toru Yoshida Koichi Hayashi Shigeki Fujitani |
| author_facet | Rimi Tanii Kuniyoshi Hayashi Takaki Naito Zoie Shui-Yee Wong Toru Yoshida Koichi Hayashi Shigeki Fujitani |
| author_sort | Rimi Tanii |
| collection | DOAJ |
| description | Aim: Although early detection of patients’ deterioration may improve outcomes, most of the detection criteria use on-the-spot values of vital signs. We investigated whether adding trend values over time enhanced the ability to predict adverse events among hospitalized patients. Methods: Patients who experienced adverse events, such as unexpected cardiac arrest or unplanned ICU admission were enrolled in this retrospective study. The association between the events and the combination of vital signs was evaluated at the time of the worst vital signs 0–8 hours before events (near the event) and at 24–48 hours before events (baseline). Multivariable logistic analysis was performed, and the area under the receiver operating characteristic curve (AUC) was used to assess the prediction power for adverse events among various combinations of vital sign parameters. Results: Among 24,509 in-patients, 54 patients experienced adverse events(cases) and 3,116 control patients eligible for data analysis were included. At the timepoint near the event, systolic blood pressure (SBP) was lower, heart rate (HR) and respiratory rate (RR) were higher in the case group, and this tendency was also observed at baseline. The AUC for event occurrence with reference to SBP, HR, and RR was lower when evaluated at baseline than at the timepoint near the event (0.85 [95%CI: 0.79–0.92] vs. 0.93 [0.88–0.97]). When the trend in RR was added to the formula constructed of baseline values of SBP, HR, and RR, the AUC increased to 0.92 [0.87–0.97]. Conclusion: Trends in RR may enhance the accuracy of predicting adverse events in hospitalized patients. |
| first_indexed | 2024-04-24T11:20:32Z |
| format | Article |
| id | doaj.art-c16580c95d2b481a864215f8c889cc09 |
| institution | Directory Open Access Journal |
| issn | 2666-5204 |
| language | English |
| last_indexed | 2024-04-24T11:20:32Z |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj.art-c16580c95d2b481a864215f8c889cc092024-04-11T04:41:58ZengElsevierResuscitation Plus2666-52042024-06-0118100628Impact of dynamic parameter of trends in vital signs on the prediction of serious events in hospitalized patients -a retrospective observational studyRimi Tanii0Kuniyoshi Hayashi1Takaki Naito2Zoie Shui-Yee Wong3Toru Yoshida4Koichi Hayashi5Shigeki Fujitani6Department of Emergency and Critical Care Medicine, St Marianna University Yokohama Seibu Hospital, 1197-1 Yasushi-cho, Asahi-ku, Yokohama, Kanagawa, Japan; Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, JapanFaculty of Data Science, Kyoto Women’s University, 35 Kitahiyoshi-cho, Imakumano, Higashiyama-ku, Kyoto, JapanDepartment of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, JapanGraduate School of Public Health, St. Luke’s International University Omura Susumu & Mieko Memorial St.Luke’s Center for Clinical Academia, 5th floor, 3-6-2 Tsukiji, Chuo-ku, Tokyo, JapanDepartment of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, JapanDepartment of Emergency and Critical Care Medicine, St Marianna University Yokohama Seibu Hospital, 1197-1 Yasushi-cho, Asahi-ku, Yokohama, Kanagawa, JapanDepartment of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, Japan; Corresponding author at: Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan.Aim: Although early detection of patients’ deterioration may improve outcomes, most of the detection criteria use on-the-spot values of vital signs. We investigated whether adding trend values over time enhanced the ability to predict adverse events among hospitalized patients. Methods: Patients who experienced adverse events, such as unexpected cardiac arrest or unplanned ICU admission were enrolled in this retrospective study. The association between the events and the combination of vital signs was evaluated at the time of the worst vital signs 0–8 hours before events (near the event) and at 24–48 hours before events (baseline). Multivariable logistic analysis was performed, and the area under the receiver operating characteristic curve (AUC) was used to assess the prediction power for adverse events among various combinations of vital sign parameters. Results: Among 24,509 in-patients, 54 patients experienced adverse events(cases) and 3,116 control patients eligible for data analysis were included. At the timepoint near the event, systolic blood pressure (SBP) was lower, heart rate (HR) and respiratory rate (RR) were higher in the case group, and this tendency was also observed at baseline. The AUC for event occurrence with reference to SBP, HR, and RR was lower when evaluated at baseline than at the timepoint near the event (0.85 [95%CI: 0.79–0.92] vs. 0.93 [0.88–0.97]). When the trend in RR was added to the formula constructed of baseline values of SBP, HR, and RR, the AUC increased to 0.92 [0.87–0.97]. Conclusion: Trends in RR may enhance the accuracy of predicting adverse events in hospitalized patients.http://www.sciencedirect.com/science/article/pii/S2666520424000791In-hospital cardiac arrestRapid response systemsVital signsDelta valuesAdverse eventsClinical deterioration |
| spellingShingle | Rimi Tanii Kuniyoshi Hayashi Takaki Naito Zoie Shui-Yee Wong Toru Yoshida Koichi Hayashi Shigeki Fujitani Impact of dynamic parameter of trends in vital signs on the prediction of serious events in hospitalized patients -a retrospective observational study Resuscitation Plus In-hospital cardiac arrest Rapid response systems Vital signs Delta values Adverse events Clinical deterioration |
| title | Impact of dynamic parameter of trends in vital signs on the prediction of serious events in hospitalized patients -a retrospective observational study |
| title_full | Impact of dynamic parameter of trends in vital signs on the prediction of serious events in hospitalized patients -a retrospective observational study |
| title_fullStr | Impact of dynamic parameter of trends in vital signs on the prediction of serious events in hospitalized patients -a retrospective observational study |
| title_full_unstemmed | Impact of dynamic parameter of trends in vital signs on the prediction of serious events in hospitalized patients -a retrospective observational study |
| title_short | Impact of dynamic parameter of trends in vital signs on the prediction of serious events in hospitalized patients -a retrospective observational study |
| title_sort | impact of dynamic parameter of trends in vital signs on the prediction of serious events in hospitalized patients a retrospective observational study |
| topic | In-hospital cardiac arrest Rapid response systems Vital signs Delta values Adverse events Clinical deterioration |
| url | http://www.sciencedirect.com/science/article/pii/S2666520424000791 |
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