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 language | English |
|---|---|
| Journal | Clinical Biochemistry |
| Number of pages | 6 |
| ISSN | 0009-9120 |
| DOIs | |
| Publication status | E-pub ahead of print - 14 Dec 2019 |
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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 journal › Journal article › Research › peer-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 -