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Abnormal routine blood tests as predictors of mortality in acutely admitted patients

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@article{b210376939e34c358f4d24de92d21b03,
title = "Abnormal routine blood tests as predictors of mortality in acutely admitted patients",
abstract = "BACKGROUND: This study aimed to improve early risk stratification in the emergency department by creating a simple blood test score based on routine biomarkers and assess its predictive ability for 30-day mortality of acutely admitted patients.METHODS: This was a secondary analysis of data from the TRIAGE II study. It included unselected acutely admitted medical and surgical patients, who had albumin, C-reactive protein, creatinine, haemoglobin, leukocytes, potassium, sodium and thrombocytes levels analysed upon admission. Patients were classified according to the number of biomarker results outside the reference range into four risk groups termed {"}very low{"}, {"}low{"}, {"}intermediate{"}, and {"}high{"} with 0-1, 2-3, 4-5 and 6-8 abnormal biomarker results, respectively. Logistic regression was used to calculate odds ratios for 30-day mortality and receiver operating characteristic was used to test the discriminative value. The primary analysis was done in patients triaged with ADAPT (Adaptive Process Triage). Subsequently, we analysed two other cohorts of acutely admitted patients.RESULTS: The TRIAGE II cohort included 17,058 eligible patients, 30-day mortality was 5.2{\%}. The primary analysis included 7,782 patients. Logistic regression adjusted for age and sex showed an OR of 24.1 (95{\%} CI 14.9-41.0) between the very low- and the high-risk group. The area under the curve (AUC) was 0.79 (95{\%} CI 0.76-0.81) for the blood test score in predicting 30-day mortality. The subsequent analyses confirmed the results.CONCLUSIONS: A blood test score based on number of routine biomarkers with an abnormal result was a predictor of 30-day mortality in acutely admitted patients.",
keywords = "Emergency department, Mortality, Risk stratification, Routine biomarkers, Triage",
author = "R{\o}nh{\o}j, {Rasmus Roenhoej} and Hasselbalch, {Rasmus B} and Martin Schultz and Mia Pries-Heje and Plesner, {Louis L} and Lisbet Ravn and Morten Lind and Jensen, {Birgitte N} and {Hoei-Hansen H{\o}i-Hansen}, Thomas and Nicholas Carlson and Christian Torp-Pedersen and Rasmussen, {Lars S} and {J H Rasmussen}, Line and Jesper Eugen-Olsen and K{\o}ber, {Lars Koeber} and Kasper Iversen",
note = "Copyright {\circledC} 2019 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.",
year = "2020",
month = "3",
doi = "10.1016/j.clinbiochem.2019.12.009",
language = "English",
volume = "77",
pages = "14--19",
journal = "Clinical Biochemistry",
issn = "0009-9120",
publisher = "Elsevier Inc",

}

RIS

TY - JOUR

T1 - Abnormal routine blood tests as predictors of mortality in acutely admitted patients

AU - Rønhøj, Rasmus Roenhoej

AU - Hasselbalch, Rasmus B

AU - Schultz, Martin

AU - Pries-Heje, Mia

AU - Plesner, Louis L

AU - Ravn, Lisbet

AU - Lind, Morten

AU - Jensen, Birgitte N

AU - Hoei-Hansen Høi-Hansen, Thomas

AU - Carlson, Nicholas

AU - Torp-Pedersen, Christian

AU - Rasmussen, Lars S

AU - J H Rasmussen, Line

AU - Eugen-Olsen, Jesper

AU - Køber, Lars Koeber

AU - Iversen, Kasper

N1 - Copyright © 2019 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

PY - 2020/3

Y1 - 2020/3

N2 - BACKGROUND: This study aimed to improve early risk stratification in the emergency department by creating a simple blood test score based on routine biomarkers and assess its predictive ability for 30-day mortality of acutely admitted patients.METHODS: This was a secondary analysis of data from the TRIAGE II study. It included unselected acutely admitted medical and surgical patients, who had albumin, C-reactive protein, creatinine, haemoglobin, leukocytes, potassium, sodium and thrombocytes levels analysed upon admission. Patients were classified according to the number of biomarker results outside the reference range into four risk groups termed "very low", "low", "intermediate", and "high" with 0-1, 2-3, 4-5 and 6-8 abnormal biomarker results, respectively. Logistic regression was used to calculate odds ratios for 30-day mortality and receiver operating characteristic was used to test the discriminative value. The primary analysis was done in patients triaged with ADAPT (Adaptive Process Triage). Subsequently, we analysed two other cohorts of acutely admitted patients.RESULTS: The TRIAGE II cohort included 17,058 eligible patients, 30-day mortality was 5.2%. The primary analysis included 7,782 patients. Logistic regression adjusted for age and sex showed an OR of 24.1 (95% CI 14.9-41.0) between the very low- and the high-risk group. The area under the curve (AUC) was 0.79 (95% CI 0.76-0.81) for the blood test score in predicting 30-day mortality. The subsequent analyses confirmed the results.CONCLUSIONS: A blood test score based on number of routine biomarkers with an abnormal result was a predictor of 30-day mortality in acutely admitted patients.

AB - BACKGROUND: This study aimed to improve early risk stratification in the emergency department by creating a simple blood test score based on routine biomarkers and assess its predictive ability for 30-day mortality of acutely admitted patients.METHODS: This was a secondary analysis of data from the TRIAGE II study. It included unselected acutely admitted medical and surgical patients, who had albumin, C-reactive protein, creatinine, haemoglobin, leukocytes, potassium, sodium and thrombocytes levels analysed upon admission. Patients were classified according to the number of biomarker results outside the reference range into four risk groups termed "very low", "low", "intermediate", and "high" with 0-1, 2-3, 4-5 and 6-8 abnormal biomarker results, respectively. Logistic regression was used to calculate odds ratios for 30-day mortality and receiver operating characteristic was used to test the discriminative value. The primary analysis was done in patients triaged with ADAPT (Adaptive Process Triage). Subsequently, we analysed two other cohorts of acutely admitted patients.RESULTS: The TRIAGE II cohort included 17,058 eligible patients, 30-day mortality was 5.2%. The primary analysis included 7,782 patients. Logistic regression adjusted for age and sex showed an OR of 24.1 (95% CI 14.9-41.0) between the very low- and the high-risk group. The area under the curve (AUC) was 0.79 (95% CI 0.76-0.81) for the blood test score in predicting 30-day mortality. The subsequent analyses confirmed the results.CONCLUSIONS: A blood test score based on number of routine biomarkers with an abnormal result was a predictor of 30-day mortality in acutely admitted patients.

KW - Emergency department

KW - Mortality

KW - Risk stratification

KW - Routine biomarkers

KW - Triage

U2 - 10.1016/j.clinbiochem.2019.12.009

DO - 10.1016/j.clinbiochem.2019.12.009

M3 - Journal article

VL - 77

SP - 14

EP - 19

JO - Clinical Biochemistry

JF - Clinical Biochemistry

SN - 0009-9120

ER -

ID: 58645894