干旱区生态环境知识资源中心(Arid): Admission diagnosis and mortality risk prediction in a contemporary cardiac intensive care unit population

Arid

DOI	10.1016/j.ahj.2020.02.018
	Admission diagnosis and mortality risk prediction in a contemporary cardiac intensive care unit population
	Jentzer, Jacob C.1,2; van Diepen, Sean 3,4; Murphree, Dennis H.5; Ismail, Abdalla S.6; Keegan, Mark T.7; Morrow, David A.8,9; Barsness, Gregory W.1; Anavekar, Nandan S.1
通讯作者	Jentzer, Jacob C.
来源期刊	AMERICAN HEART JOURNAL
ISSN	0002-8703
EISSN	1097-5330
出版年	2020
卷号	224 页码:57-64
英文摘要	Background Critical care risk scores can stratify mortality risk among cardiac intensive care unit (CICU) patients, yet risk score performance across common CICU admission diagnoses remains uncertain. Methods We evaluated performance of the Acute Physiology and Chronic Health Evaluation (APACHE)-III, APACHE-IV, Sequential Organ Failure Assessment (SOFA) and Oxford Acute Severity of Illness Score (OASIS) scores at the time of CICU admission in common CICU admission diagnoses. Using a database of 9,898 unique CICU patients admitted between 2007 and 2015, we compared the discrimination (c-statistic) and calibration (Hosmer-Lemeshow statistic) of each risk score in patients with selected admission diagnoses. Results Overall hospital mortality was 9.2%. The 3182 (32%) patients with a critical care diagnosis such as cardiac arrest, shock, respiratory failure, or sepsis accounted for >85% of all hospital deaths. Mortality discrimination by each risk score was comparable in each admission diagnosis (c-statistic 95% CI values were generally overlapping for all scores), although calibration was variable and best with APACHE-III. The c-statistic values for each score were 0.85-0.86 among patients with acute coronary syndromes, and 0.76-0.79 among patients with heart failure. Discrimination for each risk score was lower in patients with critical care diagnoses (c-statistic range 0.68-0.78) compared to non-critical cardiac diagnoses (c-statistic range 0.76-0.86). Conclusions The tested risk scores demonstrated inconsistent performance for mortality risk stratification across admission diagnoses in this CICU population, emphasizing the need to develop improved tools for mortality risk prediction among critically-ill CICU patients.
类型	Article
语种	英语
国家	USA ; Canada
收录类别	SCI-E
WOS记录号	WOS:000540371700008
WOS关键词	HOSPITAL MORTALITY ; ACUTE PHYSIOLOGY ; APACHE IV ; ILLNESS ; FAILURE ; SCORE ; VALIDATION ; SEVERITY ; REGISTRY
WOS类目	Cardiac & Cardiovascular Systems
WOS研究方向	Cardiovascular System & Cardiology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/318729
作者单位	1.Mayo Clin, Dept Cardiovasc Med, 200 First St SW, Rochester, MN 55905 USA; 2.Mayo Clin, Div Pulm & Crit Care Med, Dept Internal Med, 200 First St SW, Rochester, MN 55905 USA; 3.Univ Alberta Hosp, Dept Crit Care Med, Edmonton, AB, Canada; 4.Univ Alberta Hosp, Div Cardiol, Dept Med, Edmonton, AB, Canada; 5.Mayo Clin, Dept Hlth Sci Res, Rochester, MN 55905 USA; 6.Mayo Clin, Multidisciplinary Epidemiol & Translat Res Intens, Rochester, MN 55905 USA; 7.Mayo Clin, Dept Anesthesiol & Perioperat Med, Rochester, MN 55905 USA; 8.Brigham & Womens Hosp, Div Cardiovasc, TIMI Study Grp, 75 Francis St, Boston, MA 02115 USA; 9.Harvard Med Sch, Boston, MA 02115 USA
推荐引用方式 GB/T 7714	Jentzer, Jacob C.,van Diepen, Sean,Murphree, Dennis H.,et al. Admission diagnosis and mortality risk prediction in a contemporary cardiac intensive care unit population[J],2020,224:57-64.
APA	Jentzer, Jacob C..,van Diepen, Sean.,Murphree, Dennis H..,Ismail, Abdalla S..,Keegan, Mark T..,...&Anavekar, Nandan S..(2020).Admission diagnosis and mortality risk prediction in a contemporary cardiac intensive care unit population.AMERICAN HEART JOURNAL,224,57-64.
MLA	Jentzer, Jacob C.,et al."Admission diagnosis and mortality risk prediction in a contemporary cardiac intensive care unit population".AMERICAN HEART JOURNAL 224(2020):57-64.