Severity Trajectories of Pediatric Inpatients Using the Criticality Index

Objectives: To assess severity of illness trajectories described by the Criticality Index for survivors and deaths in five patient groups defined by the sequence of patient care in ICU and routine patient care locations. Design: The Criticality Index developed using a calibrated, deep neural network, measures severity of illness using physiology, therapies, and therapeutic intensity. Criticality Index values in sequential 6-hour time periods described severity trajectories. Setting: Hospitals with pediatric inpatient and ICU care. Patients: Pediatric patients never cared for in an ICU (n = 20,091), patients only cared for in the ICU (n = 2,096) and patients cared for in both ICU and non-ICU care locations (n = 17,023) from 2009 to 2016 Health Facts database (Cerner Corporation, Kansas City, MO). Interventions: None. Measurements and Main Results: Criticality Index values were consistent with clinical experience. The median (25–75th percentile) ICU Criticality Index values (0.878 [0.696–0.966]) were more than 80-fold higher than the non-ICU values (0.010 [0.002–0.099]). Non-ICU Criticality Index values for patients transferred to the ICU were 40-fold higher than those never transferred to the ICU (0.164 vs 0.004). The median for ICU deaths was higher than ICU survivors (0.983 vs 0.875) (p
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Online Clinical Investigations Source Type: research