Digital Commons Network^™

Accessibility, Relevance, And Impact Of A Symptom Monitoring Tool For Home Hospice Care: Theory Elaboration And Qualitative Assessment, Karla T Washington, Debra Parker Oliver, Allison K Donehower, Patrick White, Jacquelyn J Benson, Patrick G Lyons, George Demiris

2020-Current year OA Pubs

BACKGROUND: Early users found Engagement and Visualization to Improve Symptoms in Oncology Care (ENVISION), a web-based application designed to improve home management of hospice patients' symptoms and support patients' and family caregivers' well-being, to be generally useful and easy to use. However, they also raised concerns about potential challenges users with limited technological proficiency might experience.

OBJECTIVE: We sought to concurrently accomplish two interrelated study aims: (1) to develop a conceptual framework of digital inclusivity for health information systems and (2) to apply the framework in evaluating the digital inclusivity of the ENVISION application.

METHODS: We engaged ENVISION users (N=34) …

Long-Term Outcomes Of Patients With Large B-Cell Lymphoma Treated With Axicabtagene Ciloleucel And Prophylactic Corticosteroids, Olalekan O Oluwole, Nancy L Bartlett, Et Al.

2020-Current year OA Pubs

ZUMA-1 safety management cohort 6 investigated the impact of prophylactic corticosteroids and earlier corticosteroids and/or tocilizumab on the incidence and severity of cytokine release syndrome (CRS) and neurologic events (NEs) following axicabtagene ciloleucel (axi-cel) in patients with relapsed/refractory large B-cell lymphoma (R/R LBCL). Prior analyses of cohort 6 with limited follow-up demonstrated no Grade ≥3 CRS, a low rate of NEs, and high response rates, without negatively impacting axi-cel pharmacokinetics. Herein, long-term outcomes of cohort 6 (N = 40) are reported (median follow-up, 26.9 months). Since the 1-year analysis (Oluwole, et al. Blood. 2022;138[suppl 1]:2832), no new CRS was reported. …

Predictors Of Digital Amputation In Diabetic Patients With Surgically Treated Finger Infections, Ella Gibson, Carrie R Bettlach, Emma Payne, John Daines, Linh Vuong, Corinne Merrill, Ida K Fox, Mitchell A Pet

2020-Current year OA Pubs

BACKGROUND: Diabetes is a well-established risk factor for severe digital infection, and patients are more likely to require digital amputation for adequate source control. This study aims to identify factors predictive of digital amputation compared with preservation in patients with diabetes who present with surgically treated finger infections.

METHODS: Current Procedural Terminology (CPT) and International Classification of Diseases Versions 9 and 10 (ICD-9/10) databases from a single academic medical center were queried to identify patients with type 1 or type 2 diabetes mellitus who underwent surgical treatment in the operating room for treatment of a digital infection from 2010 to …

Impact Of Palliative Care Utilization Among Kidney Cancer Patients In Us Hospitals: A National-Scale Analysis, Rushin Patel, Mrunal Patel, Darshil Patel, Chieh Yang, Afoma Onyechi, Jessica Ohemeng-Dapaah, Zalak Patel, Safia Shaikh

2020-Current year OA Pubs

No abstract provided.

Racial Differences In Treatment And Survival Among Older Patients With Multiple Myeloma, Rong Wang, Natalia Neparidze, Xiaomei Ma, Graham A Colditz, Su-Hsin Chang, Shi-Yi Wang

2020-Current year OA Pubs

BACKGROUND: Treatments for multiple myeloma (MM) have evolved over time and improved MM survival. While racial differences in MM treatment and prognosis between non-Hispanic African American (NHAA) and non-Hispanic White (NHW) patients are well-established, it is unclear whether they have persisted after the introduction of novel agents.

METHODS: Using the Surveillance, Epidemiology, and End Results-Medicare linked database, our study investigated racial difference in the receipt of treatment within 1 year following diagnosis and assessed survival outcomes among Medicare beneficiaries (≥66 years) diagnosed with MM from 2007 to 2017. We applied multivariable Cox proportional hazards models to estimate the association between …

Adverse Outcomes And An Immunosuppressed Endotype In Septic Patients With Reduced Ifn-Γ Elispot, Evan L. Barrios, Drew E. Del Toro, Alexandra Dram, Sandra Meszaros, Sydney Miles, Andrew H. Walton, Anne M. Drewry, Isaiah R. Turnbull, Richard S Hotchkiss, Et Al.

2020-Current year OA Pubs

BACKGROUNDSepsis remains a major clinical challenge for which successful treatment requires greater precision in identifying patients at increased risk of adverse outcomes requiring different therapeutic approaches. Predicting clinical outcomes and immunological endotyping of septic patients generally relies on using blood protein or mRNA biomarkers, or static cell phenotyping. Here, we sought to determine whether functional immune responsiveness would yield improved precision.METHODSAn ex vivo whole-blood enzyme-linked immunosorbent spot (ELISpot) assay for cellular production of interferon γ (IFN-γ) was evaluated in 107 septic and 68 nonseptic patients from 5 academic health centers using blood samples collected on days 1, 4, and 7 …

Adherence To Practice Parameters In Medicare Beneficiaries With Amyotrophic Lateral Sclerosis, Osvaldo J. Laurido-Soto, Irene M. Faust, Susan Searles Nielsen, Brad A. Racette

2020-Current year OA Pubs

OBJECTIVE: Physician adherence to evidence-based clinical practice parameters impacts outcomes of amyotrophic lateral sclerosis (ALS) patients. We sought to investigate compliance with the 2009 practice parameters for treatment of ALS patients in the United States, and sociodemographic and provider characteristics associated with adherence.

METHODS: In this population-based, retrospective cohort study of incident ALS patients in 2009-2014, we included all Medicare beneficiaries age ≥20 with ≥1 International Classification of Diseases, Ninth Revision, Clinical Modification ALS code (335.20) in 2009 and no prior years (N = 8,575). Variables of interest included race/ethnicity, sex, age, urban residence, Area Deprivation Index (ADI), and provider …

Was Covid-19 Associated With Worsening Inequities In Stroke Treatment And Outcomes?, Laurent G Glance, Curtis G Benesch, Karen E Joynt Maddox, Matthew T Bender, Jingjing Shang, Patricia W Stone, Stewart J Lustik, Jacob W Nadler, Christopher Galton, Andrew W Dick

2020-Current year OA Pubs

Background COVID-19 stressed hospitals and may have disproportionately affected the stroke outcomes and treatment of Black and Hispanic individuals. Methods and Results This retrospective study used 100% Medicare Provider Analysis and Review file data from between 2016 and 2020. We used interrupted time series analyses to examine whether the COVID-19 pandemic exacerbated disparities in stroke outcomes and reperfusion therapy. Among 1 142 560 hospitalizations for acute ischemic strokes, 90 912 (8.0%) were Hispanic individuals; 162 752 (14.2%) were non-Hispanic Black individuals; and 888 896 (77.8%) were non-Hispanic White individuals. The adjusted odds of mortality increased by 51% (adjusted odds ratio …

Management Of Constipation In Hospitalized Patients, Gregory S Sayuk, Qi T Yu, Corey Shy

2020-Current year OA Pubs

Constipation is frequently encountered in hospital settings and can have potentially serious consequences yet is often underrecognized and undertreated. Opioid-induced constipation is a common cause of constipation in hospitalized patients. Opioids induce constipation through agonistic effects on enteric µ-opioid receptors. This review aims to provide insight on the identification and management of constipation in inpatient settings, with a particular focus on opioid-induced constipation. Constipation assessment should be routinely initiated at hospital admission and can be facilitated by thorough symptom assessments; relevant patient history, including recent medication use; physical examination; and patient assessment tools developed to evaluate the impact of constipation. …

The Covid-19 Pandemic And Associated Inequities In Acute Myocardial Infarction Treatment And Outcomes, Laurent G Glance, Karen E Joynt Maddox, Jingjing Shang, Patricia W Stone, Stewart J Lustik, Peter W Knight, Andrew W Dick

2020-Current year OA Pubs

IMPORTANCE: The COVID-19 pandemic disrupted usual care for emergent conditions, such as acute myocardial infarction (AMI). Understanding whether Black and Hispanic individuals experiencing AMI had greater increases in poor outcomes compared with White individuals during the pandemic has important equity implications.

OBJECTIVE: To investigate whether the COVID-19 pandemic was associated with increased disparities in treatment and outcomes among Medicare patients hospitalized with AMI.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used Medicare data for patients hospitalized with AMI between January 2016 and November 2020. Patients were categorized as Hispanic, non-Hispanic Black, and non-Hispanic White. The association between race and ethnicity …

Advanced Care Planning For Hospitalized Patients Following Clinician Notification Of Patient Mortality By A Machine Learning Algorithm, Stephen Chi, Seunghwan Kim, Matthew Reuter, Katharine Ponzillo, Debra Parker Oliver, Randi Foraker, Kevin Heard, Jingxia Liu, Kyle Pitzer, Patrick White, Nathan Moore

2020-Current year OA Pubs

IMPORTANCE: Goal-concordant care is an ongoing challenge in hospital settings. Identification of high mortality risk within 30 days may call attention to the need to have serious illness conversations, including the documentation of patient goals of care.

OBJECTIVE: To examine goals of care discussions (GOCDs) in a community hospital setting with patients identified as having a high risk of mortality by a machine learning mortality prediction algorithm.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study took place at community hospitals within 1 health care system. Participants included adult patients with a high risk of 30-day mortality who were admitted to 1 …

Advance Care Planning And Health-Related Quality Of Life In Huntington Disease: Results From A Multicenter National Study, Leonard L Sokol, Jonathan P Troost, Danny Bega, Benzi M Kluger, Holly G Prigerson, Martha Nance, Samuel Frank, Joel S Perlmutter, Praveen Dayalu, David Cella, Noelle E Carlozzi

2020-Current year OA Pubs

OBJECTIVE: With Huntington disease (HD), a fatal neurodegenerative disease where the prevalence of suicidal thoughts and behavior (STB) remains elevated as compared to other neurological disorders, it is unknown whether STB and health-related quality of life (HRQoL) affect plans for the end of life or more broadly, advance care planning (ACP). Conversely, it is unknown whether ACP would provoke future changes to STB and HRQoL. Therefore, we sought to evaluate whether STB and HRQoL patient-reported outcomes (PROs) contribute to ACP and whether ACP relates to changes in STB and HRQoL at 24 months.

METHODS: HD-validated clinician- and patient-assessments (i.e., HRQoL …

Social Determinants, Cardiovascular Disease, And Health Care Cost: A Nationwide Study In The United States Using Machine Learning, Feinuo Sun, Jie Yao, Shichao Du, Feng Qian, Allison A Appleton, Cui Tao, Hua Xu, Lei Liu, Qi Dai, Brian T Joyce, Drew R Nannini, Lifang Hou, Kai Zhang

2020-Current year OA Pubs

Background Existing studies on cardiovascular diseases (CVDs) often focus on individual-level behavioral risk factors, but research examining social determinants is limited. This study applies a novel machine learning approach to identify the key predictors of county-level care costs and prevalence of CVDs (including atrial fibrillation, acute myocardial infarction, congestive heart failure, and ischemic heart disease). Methods and Results We applied the extreme gradient boosting machine learning approach to a total of 3137 counties. Data are from the

Association Between Community-Level Social Risk And Spending Among Medicare Beneficiaries: Implications For Social Risk Adjustment And Health Equity, Brian W Powers, Jose F Figueroa, Melanie Canterberry, Suhas Gondi, Stephanie M Franklin, William H Shrank, Karen E Joynt Maddox

2020-Current year OA Pubs

IMPORTANCE: Payers are increasingly using approaches to risk adjustment that incorporate community-level measures of social risk with the goal of better aligning value-based payment models with improvements in health equity.

OBJECTIVE: To examine the association between community-level social risk and health care spending and explore how incorporating community-level social risk influences risk adjustment for Medicare beneficiaries.

DESIGN, SETTING, AND PARTICIPANTS: Using data from a Medicare Advantage plan linked with survey data on self-reported social needs, this cross-sectional study estimated health care spending health care spending was estimated as a function of demographics and clinical characteristics, with and without the inclusion …

Incidence, Attributable Mortality, And Healthcare And Out-Of-Pocket Costs Of Clostridioides Difficile Infection In Us Medicare Advantage Enrollees, Holly Yu, Tamuno Alfred, Jennifer L Nguyen, Jingying Zhou, Margaret A Olsen

2020-Current year OA Pubs

BACKGROUND: US attributable Clostridioides difficile infection (CDI) mortality and cost data are primarily from Medicare fee-for-service populations, and little is known about Medicare Advantage Enrollees (MAEs). This study evaluated CDI incidence among MAEs from 2012 to 2019 and determined attributable mortality and costs by comparing MAEs with and without CDI occurring in 2018.

METHODS: This retrospective cohort study assessed CDI incidence and associated mortality and costs for eligible MAEs ≥65 years of age using the de-identified Optum Clinformatics Data Mart database (Optum; Eden Prairie, Minnesota, USA). Outcomes included mortality, healthcare utilization, and costs, which were assessed via a propensity score-matched …

Identification Of Patients With Ovarian Cancer Experiencing The Highest Benefit From Bevacizumab In The First-Line Setting On The Basis Of Their Tumor-Intrinsic Chemosensitivity (Kelim): The Gog-0218 Validation Study, Benoit You, David Mutch, Et Al.

2020-Current year OA Pubs

PURPOSE: In patients with high-grade ovarian cancer, predictors of bevacizumab efficacy in first-line setting are needed. In the ICON-7 trial, a poor tumor intrinsic chemosensitivity (defined by unfavorable modeled cancer antigen-125 [CA-125] ELIMination rate constant K [KELIM] score) was a predictive biomarker. Only the patients with high-risk disease (suboptimally resected stage III, or stage IV) exhibiting unfavorable KELIM score < 1.0 had overall survival (OS) benefit from bevacizumab (median: 29.7

METHODS: In GOG-0218, 1,873 patients were treated with carboplatin-paclitaxel ± concurrent-maintenance bevacizumab/placebo. Patient KELIM values were calculated with CA-125 kinetics during the first 100 chemotherapy days by the Lyon University team. The association between KELIM score (favorable ≥ 1.0, or unfavorable …

Phase Iii Trial Of Chemoradiotherapy With Temozolomide Plus Nivolumab Or Placebo For Newly Diagnosed Glioblastoma With Methylated Mgmt Promoter, Michael Lim, George Ansstas, Et Al.

2020-Current year OA Pubs

BACKGROUND: Nearly all patients with newly diagnosed glioblastoma experience recurrence following standard-of-care radiotherapy (RT) + temozolomide (TMZ). The purpose of the phase III randomized CheckMate 548 study was to evaluate RT + TMZ combined with the immune checkpoint inhibitor nivolumab (NIVO) or placebo (PBO) in patients with newly diagnosed glioblastoma with methylated MGMT promoter (NCT02667587).

METHODS: Patients (N = 716) were randomized 1:1 to NIVO [(240 mg every 2 weeks × 8, then 480 mg every 4 weeks) + RT (60 Gy over 6 weeks) + TMZ (75 mg/m2 once daily during RT, then 150-200 mg/m2 once daily on days …

Hospital Trajectories And Early Predictors Of Clinical Outcomes Differ Between Sars-Cov-2 And Influenza Pneumonia, Patrick G Lyons, Aaloke Mody, Alice Bewley, Katherine Dittman, Aisling Doyle, Samuel L Windham, Tej M Patel, Bharat Neelam Raju, Matthew Keller, Andrew P Michelson, Thomas Kannampallil, Elvin H Geng, Pratik Sinha, Et Al.

2020-Current year OA Pubs

BACKGROUND: A comparison of pneumonias due to SARS-CoV-2 and influenza, in terms of clinical course and predictors of outcomes, might inform prognosis and resource management. We aimed to compare clinical course and outcome predictors in SARS-CoV-2 and influenza pneumonia using multi-state modelling and supervised machine learning on clinical data among hospitalised patients.

METHODS: This multicenter retrospective cohort study of patients hospitalised with SARS-CoV-2 (March-December 2020) or influenza (Jan 2015-March 2020) pneumonia had the composite of hospital mortality and hospice discharge as the primary outcome. Multi-state models compared differences in oxygenation/ventilatory utilisation between pneumonias longitudinally throughout hospitalisation. Differences in predictors of …

A Retrospective Study On Use Of Palliative Care For Patients With Alcohol Related End Stage Liver Disease In United States, Kamesh Gupta, Bandhul Hans, Ahmad Khan, Syed Hamza Sohail, Devika Kapuria, Chris Chang

2020-Current year OA Pubs

BACKGROUND: Palliative care (PC) has been shown to be beneficial in end stage liver disease (ESLD), yet the hospitalization data for PC utilization is unknown.

AIM: To identify the trend of PC utilization for the special population of alcohol-associated ESLD patients, factors affecting its use and ascertain its impact on healthcare utilization.

METHODS: We analyzed around 78 million discharges from the 2007-2014 national inpatient sample and 2010-2014 national readmission database including adult patients admitted for decompensated alcohol-associated cirrhosis. We identified patients with PC consultation as a secondary diagnosis. Odds ratios (OR) and means were adjusted for confounders using multivariate regression …

Addressing Futility: A Practical Approach, Piroska K. Kopar, Adrienne Visani, Kyler Squirrell, Douglas E. Brown

2020-Current year OA Pubs

UNLABELLED: Limiting or withdrawing nonbeneficial medical care is considered ethically responsible throughout most of critical care and medical ethics literature. Practically, however, setting limits to treatment is often challenging. We review the literature to identify best practices for using the definition of futility as an anchoring concept to aid the ethical practice of ICU clinicians.

DATA SOURCES: Source data were obtained from a PubMed literature review.

STUDY SELECTION: English language articles were chosen based on relevance to medical futility ethics, end-of-life care in the ICU, or communication and conflict mitigation strategies.

DATA EXTRACTION: Independent evaluation of selected articles for recurrent …

A Rare Case Of Pontocerebellar Hypoplasia Type 1b With Literature Review, Ana C Spyridakis, Ying Cao, Florentina Litra

2020-Current year OA Pubs

A full-term female newborn was transferred to our neonatal intensive care unit (NICU) on day two of life for hypotonia. Physical examination was significant for overriding sutures, displaced small anterior fontanelle, axial hypotonia, extremity hypertonia, and slow deep tendon reflexes. She was also noted to have stridor with crying but had unlabored breathing without oxygen requirements and a normal heart examination. A brain magnetic resonance imaging (MRI) showed a large cisterna magna and cerebellar hypoplasia with the majority of the cerebellar vermis present, suggesting a possible Dandy-Walker variant (cerebellar vermis hypoplasia). Head computed tomography showed areas of close approximation of …

The Novel Data Collection And Analytics Tools For Remote Patient Monitoring In Heart Failure (Nov-Rpm-Hf) Trial: Protocol For A Single-Center Prospective Trial, Ankit Bhatia, Gregory Ewald, Thomas Maddox

2020-Current year OA Pubs

BACKGROUND: Heart failure remains a leading cause of mortality and a major driver of health care utilization. Despite numerous medical advances in heart failure, associated hospitalizations continue to increase, owing largely to suboptimal outpatient management. Remote patient monitoring (RPM) aims to further address this current need in heart failure care by providing data to clinical teams to act pre-emptively to address clinical decompensation. However, to date, RPM approaches using noninvasive home-based patient sensors have failed to demonstrate clinical efficacy.

OBJECTIVE: The Novel Data Collection and Analytics Tools for Remote Patient Monitoring in Heart Failure (Nov-RPM-HF) Trial aims to address current …

Rate Of Infarct-Edema Growth On Ct Predicts Need For Surgical Intervention And Clinical Outcome In Patients With Cerebellar Infarction, Yan Wang, Michael M Binkley, Min Qiao, Amanda Pardon, Salah Keyrouz, Rajat Dhar, Andria L Ford

2020-Current year OA Pubs

BACKGROUND: Up to 20% of patients with cerebellar infarcts will develop malignant edema and deteriorate clinically. Radiologic measures, such as initial infarct size, aid in identifying individuals at risk. Studies of anterior circulation stroke suggest that mapping early edema formation improves the ability to predict deterioration; however, the kinetics of edema in the posterior fossa have not been well characterized. We hypothesized that faster edema growth within the first hours after acute cerebellar stroke would be an indicator for individuals requiring surgical intervention and those with worse neurological outcomes.

METHODS: Consecutive patients admitted to the neurological intensive care unit with …

Prolonged Response Of Recurrent Idh-Wild-Type Glioblastoma To Laser Interstitial Thermal Therapy With Pembrolizumab, Helen Hwang, Jiayi Huang, Karam Khaddour, Omar H Butt, George Ansstas, Jie Chen, Ruth Gn Katumba, Albert H Kim, Eric C Leuthardt, Jian L Campian

2020-Current year OA Pubs

Despite the improved understanding of the molecular and genetic heterogeneity of glioblastoma, there is still an unmet need for better therapeutics, as treatment approaches have remained unchanged in recent years. Research into the role of the immune microenvironment has generated enthusiasm for testing immunotherapy (specifically, immune checkpoint inhibitors). However, to date, trials of immunotherapy in glioblastoma have not demonstrated a survival advantage. Combination approaches aimed at optimally inducing response to immune checkpoint inhibitors with radiotherapy are currently being investigated. Herein, the authors describe their experience of the potential benefit and clinical outcomes of using combination pembrolizumab (an immune checkpoint inhibitor) …

Disseminated Infection Due To Neocosmospora (Fusarium) Falciformis In A Patient With Acute Myelogenous Leukemia, Ra'ed Jabr, Rachael M Liesman, Venkata Rakesh Sethapati, D Matthew Shoemaker, Andrej Spec, Wissam El Atrouni

2020-Current year OA Pubs

No abstract provided.

Molecular Heterogeneity In Pediatric Malignant Rhabdoid Tumors In Patients With Multi-Organ Involvement, Katherine E Miller, Margaret Shatara, Et Al

2020-Current year OA Pubs

Rhabdoid tumors (RTs) of the brain (atypical teratoid/rhabdoid tumor; AT/RT) and extracranial sites (most often the kidney; RTK) are malignant tumors predominantly occurring in children, frequently those with

Identification And Management Of Aggressive Meningiomas, Bhuvic Patel, Rupen Desai, Sangami Pugazenthi, Omar H Butt, Jiayi Huang, Albert H Kim

2020-Current year OA Pubs

Meningiomas are common primary central nervous system tumors derived from the meninges, with management most frequently entailing serial monitoring or a combination of surgery and/or radiation therapy. Although often considered benign lesions, meningiomas can not only be surgically inaccessible but also exhibit aggressive growth and recurrence. In such cases, adjuvant radiation and systemic therapy may be required for tumor control. In this review, we briefly describe the current WHO grading scale for meningioma and provide demonstrative cases of treatment-resistant meningiomas. We also summarize frequently observed molecular abnormalities and their correlation with intracranial location and recurrence rate. We then describe how …

Prescribing Unproven Cancer Drugs: Physician Perspectives On Expanded Access And Right To Try, Haley Manley, Bryan A Sisk, Zubin Master, Christopher Thomas Scott

2020-Current year OA Pubs

BACKGROUND: For gravely ill patients who have no treatment options and who are ineligible for clinical trials, the US Food and Drug Administration (FDA) established the Expanded Access Program (EAP). Motivated by efforts to weaken FDA regulation and sold as providing greater access to experimental drugs, the federal Right to Try Act (RTT) was passed in 2017. It reduces FDA oversight by not requiring physicians to report safety data and foregoes approval of protocols by local institutional review boards.

METHODS: This study explored the views of 17 neuro-oncologists from 15 different academic medical centers with varying experience with EAP and …

Low Risk For Developing Diabetes Among The Offspring Of Individuals With Exceptional Longevity And Their Spouses, Iva Miljkovic, Ryan Cvejkus, Ping An, Bharat Thyagarajan, Kaare Christensen, Mary Wojczynski, Nicole Schupf, Joseph M Zmuda

2020-Current year OA Pubs

Little is known about the risk of type 2 diabetes (T2D) among the offspring of individuals with exceptional longevity. We determined the incidence of and potential risk and protective factors for T2D among the offspring of probands and offspring's spouses (mean age=60 years, range 32-88 years) in the Long Life Family Study (LLFS), a multicenter cohort study of 583 two-generation families with a clustering of healthy aging and exceptional longevity. Incident T2D was defined as fasting serum glucose ≥126 mg/dl, or HbA1c of ≥6.5%, or self-reported with doctor diagnosis of T2D, or the use of anti-diabetic medication during a mean …

Sepsis Prediction For The General Ward Setting, Sean C Yu, Aditi Gupta, Kevin D Betthauser, Patrick G Lyons, Albert M Lai, Marin H Kollef, Philip R O Payne, Andrew P Michelson

2020-Current year OA Pubs

OBJECTIVE: To develop and evaluate a sepsis prediction model for the general ward setting and extend the evaluation through a novel pseudo-prospective trial design.

DESIGN: Retrospective analysis of data extracted from electronic health records (EHR).

SETTING: Single, tertiary-care academic medical center in St. Louis, MO, USA.

PATIENTS: Adult, non-surgical inpatients admitted between January 1, 2012 and June 1, 2019.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN RESULTS: Of the 70,034 included patient encounters, 3.1% were septic based on the Sepsis-3 criteria. Features were generated from the EHR data and were used to develop a machine learning model to predict sepsis 6-h ahead …