title: Relationship between mortality and first-day events index from routinely gathered physiological variables in ICU patients.
abstract: OBJECTIVE
  To test the hypothesis that the degree and duration of alterations in physiological variables routinely gathered by intensive care unit (ICU) monitoring systems during the first day of admission to the ICU, together with a few additional routinely recorded data, yield information similar to that obtained by traditional mortality prediction systems.
  
  
  METHODS
  A prospective observational multicenter study (EURICUS II) was carried out.
  
  
  METHODS
  Fifty-five European ICUs.
  
  
  METHODS
  A total of 17,598 consecutive patients admitted to the ICU over a 10-month period.
  
  
  METHODS
  None.
  
  
  METHODS
  Hourly data were manually gathered on alterations or "events" in systolic blood pressure, heart rate and oxygen saturation throughout ICU stay to construct an events index and mortality prediction models.
  
  
  RESULTS
  The mean first-day events index was 6.37±10.47 points, and was significantly associated to mortality (p<0.001), with a discrimination capacity for hospital mortality of 0.666 (area under the ROC curve). A second index included this first-day events index, age, pre-admission location, and the Glasgow coma score. A model constructed with this second index plus diagnosis upon admission was validated by using the Jackknife method (Hosmer-Lemeshow, H=13.8554, insignificant); the area under ROC curve was 0.818.
  
  
  CONCLUSIONS
  A prognostic index with performance very similar to that of habitual systems can be constructed from routine ICU data with only a few patient characteristics. These results may serve as a guide for the possible automated construction of ICU prognostic indexes.
authors: Carlos Haya University Hospital, Málaga, Spain.
authors: R
authors: R
authors: Rivera-Fernández
authors: E
authors: E
authors: Castillo-Lorente
authors: R
authors: R
authors: Nap
authors: G
authors: G
authors: Vázquez-Mata
authors: D
authors: D
authors: Reis Miranda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D055986:Vital Signs