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dc.contributor.authorFaisal, Muhammad*
dc.contributor.authorScally, Andy J.*
dc.contributor.authorRichardson, D.*
dc.contributor.authorBeatson, K.*
dc.contributor.authorHowes, R.*
dc.contributor.authorSpeed, K.*
dc.contributor.authorMohammed, Mohammed A.*
dc.date.accessioned2018-02-02T10:05:15Z
dc.date.available2018-02-02T10:05:15Z
dc.date.issued2018-04
dc.identifier.citationFaisal M, Scally A, Richardson D et al (2018) Development and external validation of an automated computer-aided risk score for predicting sepsis in emergency medical admissions using the patient’s first electronically recorded vital signs and blood test results. Critical Care Medicine. 46(4): 612-618.en_US
dc.identifier.urihttp://hdl.handle.net/10454/14800
dc.descriptionYesen_US
dc.description.abstractObjectives: To develop a logistic regression model to predict the risk of sepsis following emergency medical admission using the patient’s first, routinely collected, electronically recorded vital signs and blood test results and to validate this novel computer-aided risk of sepsis model, using data from another hospital. Design: Cross-sectional model development and external validation study reporting the C-statistic based on a validated optimized algorithm to identify sepsis and severe sepsis (including septic shock) from administrative hospital databases using International Classification of Diseases, 10th Edition, codes. Setting: Two acute hospitals (York Hospital - development data; Northern Lincolnshire and Goole Hospital - external validation data). Patients: Adult emergency medical admissions discharged over a 24-month period with vital signs and blood test results recorded at admission. Interventions: None. Main Results: The prevalence of sepsis and severe sepsis was lower in York Hospital (18.5% = 4,861/2,6247; 5.3% = 1,387/2,6247) than Northern Lincolnshire and Goole Hospital (25.1% = 7,773/30,996; 9.2% = 2,864/30,996). The mortality for sepsis (York Hospital: 14.5% = 704/4,861; Northern Lincolnshire and Goole Hospital: 11.6% = 899/7,773) was lower than the mortality for severe sepsis (York Hospital: 29.0% = 402/1,387; Northern Lincolnshire and Goole Hospital: 21.4% = 612/2,864). The C-statistic for computer-aided risk of sepsis in York Hospital (all sepsis 0.78; sepsis: 0.73; severe sepsis: 0.80) was similar in an external hospital setting (Northern Lincolnshire and Goole Hospital: all sepsis 0.79; sepsis: 0.70; severe sepsis: 0.81). A cutoff value of 0.2 gives reasonable performance. Conclusions: We have developed a novel, externally validated computer-aided risk of sepsis, with reasonably good performance for estimating the risk of sepsis for emergency medical admissions using the patient’s first, electronically recorded, vital signs and blood tests results. Since computer-aided risk of sepsis places no additional data collection burden on clinicians and is automated, it may now be carefully introduced and evaluated in hospitals with sufficient informatics infrastructure.en_US
dc.description.sponsorshipHealth Foundationen_US
dc.language.isoenen_US
dc.rights© 2018 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. Reproduced in accordance with the publisher's self-archiving policy.en_US
dc.subjectVital signs; Sepsis; National early warning score; Blood tests; Emergency admission; External validation; Risk prediction; Computer aided risk scoreen_US
dc.titleDevelopment and external validation of an automated computer-aided risk score for predicting sepsis in emergency medical admissions using the patient’s first electronically recorded vital signs and blood test resultsen_US
dc.status.refereedYesen_US
dc.date.Accepted2017-12-06
dc.date.application2018-01-24
dc.typeAbstracten_US
dc.type.versionAccepted Manuscripten_US
dc.identifier.doihttps://doi.org/10.1097/CCM.0000000000002967
refterms.dateFOA2019-01-25T09:39:10Z


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