Table 2

Univariate predictors of RED events (N= 23,127 patient days)
Variable Derivation Events # (%) Odds Ratio (95% CI) p
RED events a 298 (1.3)
age > 54 9,217 (39.9) 145 (1.6) 1.4 (1.14 - 1.81) 0.002
Vitals, N(%)
Temperature (°F)
≤99.5 (ref.) 20,157 (87.2) 229 (1.1) -- --
>99.5 2,970 (12.8) 69 (2.3) 2.1 (1.58 - 2.72) <0.001
Systolic Blood Pressure (mm Hg)
≤125 (ref.) 7,122 (30.8) 77 (1.1) -- --
>125 16,005 (69.2) 221 (1.4) 1.3 (0.99 - 1.66) 0.063
Respirations per minute
≤24 (ref.) 21,713 (93.9) 192 (0.9) -- --
>24 1,414 (6.1) 106 (7.5) 9.1 (7.12 - 11.59) <0.001
Pulse per minute
≤134 (ref.) 22,464 (97.1) 240 (1.1) -- --
>134 663 (2.9) 58 (8.8) 8.9 (6.59 - 11.96) <0.001
Diastolic Blood Pressure (mm Hg)
≤120 (ref.) 22,507 (97.3) 265 (1.2) -- --
>120 620 (2.7) 33 (5.3) 4.7 (3.26 - 6.84) <0.001
spO2 (%)
≤86 319 (1.4) 25 (7.8) 7.0 (4.59 - 10.74) <0.001
>86 (ref.) 22,808 (98.6) 273 (1.2) -- --
Laboratory, N(%)
Platelets (103 cells/mm3)
<100 1959 (8.5) 32 (1.6) 1.3 (0.90 - 1.89) 0.158
≥100 (ref.) 21,168 (91.5) 266 (1.3) -- --
Potassium (mEq/L)
≤2.9 155 (0.7) 9 (5.8) 5.4 (2.74 - 10.76) <0.001
2.9 - 5.1 (ref.) 21,811 (94.3) 245 (1.1) -- --
>5.1 1,161 (5.0) 44 (3.8) 3.5 (2.50 - 4.81) <0.001
Glucose (mg/dL)
≤250 (ref.) 22,219 (96.0) 276 (1.2) -- --
250 – 600 825 (3.6) 17 (2.1) 1.7 (1.02 - 2.74) 0.042
>600 83 (0.4) 5 (6.0) 5.1 (2.05 - 12.69) <0.001
Hematocrit (g/dL)
≤48 (ref.) 22,925 (99.1) 288 (1.3) -- --
> 48 202 (0.9) 10 (5.0) 4.1 (2.15 - 7.81) <0.001
Creatinine
≤1.5 (ref.) 17,937 (77.6) 201 (1.1) -- --
>1.5 5,190 (22.4) 97 (1.9) 1.7 (1.32 - 2.15) <0.001
White Blood Cell Count (103 cells/mm3)
≤11 (ref.) 19,225 (83.1) 204 (1.1) -- --
>11 3,902 (16.9) 94 (2.4) 2.3 (1.80 - 2.95) <0.001
Total Bilirubin (mg/dL)
≤1.7 (ref.) 22,172 (95.9) 271 (1.2) -- --
>1.7 955 (4.1) 27 (2.8) 2.4 (1.57 - 3.51) <0.001
Sodium (mEq/L)
≤128 983 (4.2) 29 (3.0) 2.5 (1.69 - 3.69) <0.001
128 - 143 (ref.) 21,808 (94.3) 262 (1.2) -- --
>143 336 (1.5) 7 (2.1) 1.7 (0.82 - 3.74) 0.148
pH
≤7.22 53 (0.2) 11 (20.8) 20.8 (10.60 - 40.80) <0.001
>7.22 (ref.) 23,074 (99.8) 287 (1.2) -- --
pCO2 (mm Hg)
≤22 78 (0.3) 12 (15.4) 14.8 (7.89 - 27.62) <0.001
22 - 70 (ref.) 23,020 (99.5) 280 (1.2) -- --
>70 29 (0.2) 6 (20.7) 21.2 (8.56 - 52.43) <0.001
AST (U/L)
≤250 (ref.) 22,826 (98.7) 279 (1.2) -- --
>250 301 (1.3) 19 (6.3) 5.4 (3.37 - 8.79) <0.001
Anion Gap
≤16 (ref.) 21,791 (94.2) 236 (1.1) -- --
>16 1,336 (5.8) 62 (4.6) 4.4 (3.34 - 5.91) <0.001
Albumin (g/dL)
< 3.5 2,779 (12.0) 54 (1.9) 1.6 (1.21 - 2.20) 0.001
≥3.5 (ref.) 20,348 (88.0) 244 (1.2) -- --
B-type natriuretic peptide (pg/mL)
≤100 (ref.) 21,803 (94.3) 257 (1.2) -- --
>100 1,324 (5.7) 41 (3.1) 2.7 (1.92 - 3.74) <0.001
Thyroid Stimulating Hormone (μIU/mL)
≤0.4 60 (0.3) 3 (5.0) 4.1 (1.27 - 13.10) 0.018
0.4 - 5.4 610 (2.6) 7 (1.2) 0.9 (0.42 - 1.91) 0.784
>5.4 83 (0.4) 3 (3.6) 2.9 (0.91 - 9.26) 0.071
Not measured (ref.) 22,374 (96.7) 285 (1.3) -- --
Estimated glomerular filtration rate (mL/min/1.73 m2)
≤30 3,009 (13.0) 57 (1.9) 1.6 (1.19 - 2.13) 0.002
>30 (ref.) 20,118 (87.0) 241 (1.2) -- --
Physician Orders, N(%)
Bilevel positive airway pressure 122 (0.5) 11 (9.0) 7.8 (4.18 - 14.73) <0.001
Arterial Blood Gas 1,436 (6.2) 104 (7.2) 8.7 (6.77 - 11.05) <0.001
Troponin I 3,725 (16.1) 130 (3.5) 4.1 (3.28 - 5.22) <0.001
Electrocardiogram 4,996 (21.6) 183 (3.7) 6.0 (4.71 - 7.54) <0.001
Electroencephalogram 87 (0.4) 1 (1.2) 0.9 (0.12 - 6.41) 0.908
Telemetry 1,765 (7.6) 36 (2.0) 1.7 (1.18 - 2.38) 0.004
Stat order # 1 b 1,704 (7.4) 45 (2.6) 2.3 (1.65 - 3.13) <0.001
Stat order # 2 c 2,476 (10.7) 70 (2.8) 2.6 (1.99 - 3.42) <0.001
Administered Medications, N(%)
Institute of Safe Medication Practice High Alert Medication d 9,257 (40.0) 162 (1.8) 1.8 (1.43 - 2.26) <0.001
Systemic Steroids e 758 (3.3) 13 (1.7) 1.4 (0.77 - 2.37) 0.292
Sodium Bicarbonate 423 (1.8) 16 (3.8) 3.1 (1.87 - 5.22) <0.001
Lactulose or Rifaxamin 535 (2.3) 12 (2.2) 1.8 (1.00 - 3.21) 0.051
Antidote medication f 308 (1.3) 14 (4.6) 3.8 (2.18 - 6.54) <0.001
More than one nephrotoxic agent taken concurrently g 3,580 (15.5) 60 (1.7) 1.4 (1.04 - 1.84) 0.026
More than one antibiotic agent taken concurrently h 2,549 (45.3) 46 (1.8) 1.5 (1.08 - 2.04) 0.015
Intravenous fluid bolus 1,270 (5.5) 55 (4.3) 4.0 (2.99 - 5.43) <0.001
Stat acute coronary syndrome medications i 2,436 (10.5) 43 (1.8) 1.4 (1.04 - 1.99) 0.028
Stat seizure abatement medications j 1,069 (4.6) 31 (2.9) 2.4 (1.67 - 3.55) <0.001
Summary Variables
MEWS, Mean (SD) k 2.28 (1.5) 1.6 (1.54 - 1.70) <0.001
Level of Consciousness
0 – Alert 7,580 (32.8) 156 (2.1) 3.1 (2.41 - 4.00) <0.001
1 – Responds to voice/new confusion/restlessness 543 (2.3) 23 (4.2) 6.5 (4.12 - 10.37) <0.001
2 – Responds to pain 102 (0.4) 6 (5.9) 9.2 (3.95 - 21.55) <0.001
3 – Unresponsive 32 (0.1) 13 (40.6) 101.1 (48.59 - 210.20) <0.001
Not measured (ref.) 14,870 (64.3) 100 (0.7) -- --
High Risk Floor Assignment, N(%) l 2,369 (10.2) 158 (6.7) 10.5 (8.35 - 13.27) <0.001

a Resuscitation events and death; b Stat orders for head magnetic resonance imaging or computed tomography scan, chest plain film x-rays or computed tomography scan, and abdominal ultrasonography; c Stat orders for complete blood count, bilevel positive airway pressure, arterial blood gas, troponin, electroencephalogram and electrocardiogram; d antithrombotic agents, chemotherapeutic agents, epidural or intrathecal route of administration, hypoglycemic, magnesium sulfate injection, hypertonic sodium chloride, colchicine injection, and methotrexate oral; e IV or oral prednisone, methylprednisolone, prednisolone, fludricortisone and hydrocortisone; f Protamine, naloxone, phytonadione, flumazenil; g Systemic amphotericin B (lipid and conventional), systemic aminoglycosides, scheduled daily non-steroidal anti-inflammatories, IV vancomycin, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, cyclosporine, tacrolimus, loop diuretics, penicillin antibiotics, acyclovir; h Any aminoglycoside, penicillin, cephalosporin, vancomycin, sulfa antibiotic, linezolid, doxycycline, tigecycline, fluoroquinolone, aztreonam, carbapenem, daptomycin, and nitrofurantoin; i IV metoprolol, sublingual or IV nitroglycerin and aspirin given concurrently; j intramuscular lorazepam or diazepam, phenobarbital, fosphenytoin, and phenytoin; k elements consists of systolic blood pressure, heart rate, respiratory rate, temperature, and level of consciousness; l includes floors that comprise the top 15% of events.

Alvarez et al.

Alvarez et al. BMC Medical Informatics and Decision Making 2013 13:28   doi:10.1186/1472-6947-13-28

Open Data