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

Rasmus Roenhoej Rønhøj, Rasmus B Hasselbalch, Martin Schultz, Mia Pries-Heje, Louis L Plesner, Lisbet Ravn, Morten Lind, Birgitte N Jensen, Thomas Hoei-Hansen Høi-Hansen, Nicholas Carlson, Christian Torp-Pedersen, Lars S Rasmussen, Line J H Rasmussen, Jesper Eugen-Olsen, Lars Koeber Køber, Kasper Iversen

Research output: Contribution to journalJournal articleResearchpeer-review

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 7782 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.

Original languageEnglish
JournalClinical Biochemistry
Number of pages6
ISSN0009-9120
DOIs
Publication statusE-pub ahead of print - 14 Dec 2019

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Hematologic Tests
Biomarkers
Blood
Mortality
Logistics
C-Reactive Protein
Albumins
Creatinine
Potassium
Hemoglobins
Logistic Models
Sodium
Triage
ROC Curve
Area Under Curve
Hospital Emergency Service
Reference Values
Leukocytes
Blood Platelets
Odds Ratio

Cite this

Roenhoej Rønhøj, R., Hasselbalch, R. B., Schultz, M., Pries-Heje, M., Plesner, L. L., Ravn, L., ... Iversen, K. (2019). Abnormal routine blood tests as predictors of mortality in acutely admitted patients. Clinical Biochemistry. https://doi.org/10.1016/j.clinbiochem.2019.12.009
Roenhoej Rønhøj, Rasmus ; Hasselbalch, Rasmus B ; Schultz, Martin ; Pries-Heje, Mia ; Plesner, Louis L ; Ravn, Lisbet ; Lind, Morten ; Jensen, Birgitte N ; Hoei-Hansen Høi-Hansen, Thomas ; Carlson, Nicholas ; Torp-Pedersen, Christian ; Rasmussen, Lars S ; Rasmussen, Line J H ; Eugen-Olsen, Jesper ; Koeber Køber, Lars ; Iversen, Kasper. / Abnormal routine blood tests as predictors of mortality in acutely admitted patients. In: Clinical Biochemistry. 2019.
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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 7782 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.",
author = "{Roenhoej R{\o}nh{\o}j}, Rasmus 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 Rasmussen, {Line J H} and Jesper Eugen-Olsen and {Koeber K{\o}ber}, Lars and Kasper Iversen",
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Roenhoej Rønhøj, R, Hasselbalch, RB, Schultz, M, Pries-Heje, M, Plesner, LL, Ravn, L, Lind, M, Jensen, BN, Hoei-Hansen Høi-Hansen, T, Carlson, N, Torp-Pedersen, C, Rasmussen, LS, Rasmussen, LJH, Eugen-Olsen, J, Koeber Køber, L & Iversen, K 2019, 'Abnormal routine blood tests as predictors of mortality in acutely admitted patients', Clinical Biochemistry. https://doi.org/10.1016/j.clinbiochem.2019.12.009

Abnormal routine blood tests as predictors of mortality in acutely admitted patients. / Roenhoej Rønhøj, Rasmus; Hasselbalch, Rasmus B; Schultz, Martin; Pries-Heje, Mia; Plesner, Louis L; Ravn, Lisbet; Lind, Morten; Jensen, Birgitte N; Hoei-Hansen Høi-Hansen, Thomas; Carlson, Nicholas; Torp-Pedersen, Christian; Rasmussen, Lars S; Rasmussen, Line J H; Eugen-Olsen, Jesper; Koeber Køber, Lars; Iversen, Kasper.

In: Clinical Biochemistry, 14.12.2019.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

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

AU - Roenhoej Rønhøj, Rasmus

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 - Rasmussen, Line J H

AU - Eugen-Olsen, Jesper

AU - Koeber Køber, Lars

AU - Iversen, Kasper

PY - 2019/12/14

Y1 - 2019/12/14

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 7782 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 7782 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.

U2 - 10.1016/j.clinbiochem.2019.12.009

DO - 10.1016/j.clinbiochem.2019.12.009

M3 - Journal article

C2 - 31843666

JO - Clinical Biochemistry

JF - Clinical Biochemistry

SN - 0009-9120

ER -

Roenhoej Rønhøj R, Hasselbalch RB, Schultz M, Pries-Heje M, Plesner LL, Ravn L et al. Abnormal routine blood tests as predictors of mortality in acutely admitted patients. Clinical Biochemistry. 2019 Dec 14. https://doi.org/10.1016/j.clinbiochem.2019.12.009