Department of Internal Medicine, Yale School of Medicine, New Haven, CT.
Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT.
Am Heart J. 2021 Aug;238:85-88. doi: 10.1016/j.ahj.2021.04.004. Epub 2021 Apr 20.
In this observational study, we compared the prognostic ability of an electronic health record (EHR)-derived risk score, the Rothman Index (RI), automatically derived on admission, to the first 24-hour Sequential Organ Failure Assessment (SOFA) score for outcome prediction in the modern cardiac intensive care unit (CICU). We found that while the 24-hour SOFA score provided modestly superior discrimination for both in-hospital and CICU mortality, the RI upon CICU admission had better calibration for both outcomes. Given the ubiquitous nature of EHR utilization in the United States, the RI may become an important tool to rapidly risk stratify CICU patients within the ICU and improve resource allocation.
在这项观察性研究中，我们比较了电子病历（EHR）衍生风险评分（Rothman 指数，RI）和入院后 24 小时序贯器官衰竭评估（SOFA）评分对现代心脏重症监护病房（CICU）预后的预测能力。我们发现，虽然 24 小时 SOFA 评分对院内和 CICU 死亡率的区分度略高，但 RI 在 CICU 入院时对两种结局的校准度更好。鉴于美国 EHR 的广泛应用，RI 可能成为一种在 ICU 内快速对 CICU 患者进行风险分层并改善资源分配的重要工具。
