{"title":"A Continuous Real-Time Analytic for Predicting Instability in Acute Care Rapid Response Team Activations","authors":"Ashwin Belle, Bryce Benson, Mark Salamango, Fadi Islim, Rodney Daniels, Kevin Ward","volume":167,"journal":"International Journal of Medical and Health Sciences","pagesStart":380,"pagesEnd":388,"ISSN":"1307-6892","URL":"https:\/\/publications.waset.org\/pdf\/10011586","abstract":"<p>A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic&rsquo;s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration.<\/p>\r\n","references":"[1]\tKause J, Smith G, Prytherch D, Parr M, Flabouris A, Hillman K. A comparison of antecedents to cardiac arrests, deaths and emergency intensive care admissions in Australia and New Zealand, and the United Kingdom\u2014the ACADEMIA study. Resuscitation. 2004;62(3):275\u201382. \r\n[2]\tJohnston MJ, Arora S, King D, Bouras G, Almoudaris AM, Davis R, et al. A systematic review to identify the factors that affect failure to rescue and escalation of care in surgery. Surgery. 2015;157(4):752\u201363. \r\n[3]\tMitchell IA, McKay H, Van Leuvan C, Berry R, McCutcheon C, Avard B, et al. 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Crit Care. 2014;18(1):R21.","publisher":"World Academy of Science, Engineering and Technology","index":"Open Science Index 167, 2020"}