ArticleCritical care medicine2024
Beyond Unplanned ICU Transfers: Linking a Revised Definition of Deterioration to Patient Outcomes.
Article in Critical care medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Factors underpinning the performance of implemented artificial intelligence-based patient deterioration prediction systems: reasons for selection and implications for hospitals and researchers.Journal of the American Medical Informatics Association : JAMIA · 2025Pooled it
- Implementation of Passive Deterioration Index Alerts in an Intermediate Care Unit: A Failed Early Warning System Strategy.Applied clinical informatics · 2025Article
- "Reality shock"-a qualitative exploration of helicopter emergency medical services nurses' challenges and experiences in China.Frontiers in public health · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectivesTo develop an electronic descriptor of clinical deterioration for hospitalized patients that predicts short-term mortality and identifies patient deterioration earlier than current standard definitions.
designA retrospective study using exploratory record review, quantitative analysis, and regression analyses.
settingTwelve-hospital community-academic health system. PATIENTS: All adult patients with an acute hospital encounter between January 1, 2018, and December 31, 2022.
interventionsNot applicable. MEASUREMENTS AND MAIN
resultsClinical trigger events were selected and used to create a revised electronic definition of deterioration, encompassing signals of respiratory failure, bleeding, and hypotension occurring in proximity to ICU transfer. Patients meeting the revised definition were 12.5 times more likely to die within 7 days (adjusted odds ratio 12.5; 95% CI, 8.9-17.4) and had a 95.3% longer length of stay (95% CI, 88.6-102.3%) compared with those who were transferred to the ICU or died regardless of meeting the revised definition. Among the 1812 patients who met the revised definition of deterioration before ICU transfer (52.4%), the median detection time was 157.0 min earlier (interquartile range 64.0-363.5 min).
conclusionsThe revised definition of deterioration establishes an electronic descriptor of clinical deterioration that is strongly associated with short-term mortality and length of stay and identifies deterioration over 2.5 hours earlier than ICU transfer. Incorporating the revised definition of deterioration into the training and validation of early warning system algorithms may enhance their timeliness and clinical accuracy.
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