Table 3.
Characteristics of Clusters Derived from 1,326 Patient Sequences of Instability Stabilization
| Characteristic | Stabilized fast | Stabilized Slow | Tachy-cardic | Febrile | Hypoxic | Tachy-cardic/Hypoxic | Mental/Oral/Hypoxic | Inpatient mortality | P* |
|---|---|---|---|---|---|---|---|---|---|
| Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | ||
| N (% of 1,326) | 434 (32.7) | 307 (23.2) | 120 (9.1) | 45 (3.4) | 196 (14.8) | 84 (6.3) | 108 (8.1) | 32 (2.4) | |
| Rank orders of stabilization† | |||||||||
| Average Order of Stabilization‡ | [MS-RR-BP-OI-O2-HR-T] | [BP-MS-OI-T-RR-HR-O2] | [BP-MS-OI-RR-O2-T-HR] | [MS-BP-OI- O2-RR-HR-T] | [BP-MS-OI-T-HR-RR-O2] | [BP-MS-OI-T-RR-HR-O2] | [BP-T-RR-HR-O2-MS-OI] | [T-BP-HR-RR-O2-MS-OI] | |
| Blood pressure (BP) | 1.05 (2.48) | 1.28 (1.90) | 0.51 (1.31) | 1.13 (2.27) | 1.07 (1.80) | 0.80 (1.60) | 1.22 (1.75) | 2.94 (3.34) | < 0.001 |
| Mental status (MS) | 0.98 (2.01) | 1.30 (2.03) | 1.20 (2.02) | 0.56 (1.08) | 1.38 (2.09) | 0.89 (1.55) | 5.93 (2.93) | 6.68 (3.63) | < 0.001 |
| Oral intake (OI) | 2.23 (2.64) | 2.04 (2.31) | 1.94 (2.03) | 1.84 (2.42) | 2.11 (2.10) | 1.48 (1.86) | 6.42 (2.73) | 7.93 (2.86) | < 0.001 |
| Respiratory rate (RR) | 1.05 (2.18) | 4.06 (2.14) | 2.48 (2.56) | 2.31 (2.52) | 3.16 (2.45) | 4.30 (3.40) | 2.36 (2.29) | 5.19 (3.54) | < 0.001 |
| Temperature (T) | 2.89 (3.11) | 3.44 (2.40) | 2.94 (2.56) | 7.93 (0.45) | 2.60 (2.31) | 3.29 (2.99) | 2.10 (2.19) | 1.78 (2.04) | < 0.001 |
| Heart rate (HR) | 2.42 (3.01) | 4.34 (2.06) | 8.00 (0.00) | 5.47 (2.90) | 3.03 (2.42) | 6.71 (2.42) | 2.64 (2.76) | 4.88 (3.76) | < 0.001 |
| Oxygen saturation (O2) | 2.26 (2.40) | 4.59 (2.48) | 2.71 (2.20) | 2.29 (1.93) | 8.04 (0.19) | 7.01 (2.27) | 5.08 (2.79) | 6.19 (3.68) | < 0.001 |
| Stabilization | |||||||||
| Hospitalist, n (%) | 134 (30.9) | 92 (30.0) | 39 (32.5) | 16 (35.6) | 65 (33.2) | 31 (36.9) | 34 (31.5) | 15 (46.9) | 0.61 |
| # factors stabilized at presentation | 3.81 (1.30) | 2.08 (1.34) | 2.76 (1.32) | 2.38 (1.53) | 2.43 (1.48) | 2.54 (1.28) | 1.94 (1.31) | 1.56 (0.91) | < 0.001 |
| Fully stabilized, n (%) | 411 (94.7) | 304 (99.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | < 0.001 |
| # instabilities at discharge | 0.08 (0.39) | 0.01 (0.10) | 1.01 (0.09) | 1.62 (0.68) | 1.03 (0.19) | 2.13 (0.65) | 1.89 (0.90) | 3.19 (1.23) | < 0.001 |
| Days to maximum stabilization§ | 2.14 (2.04) | 4.45 (4.19) | 2.56 (3.35) | 1.60 (1.84) | 2.94 (3.32) | 2.39 (2.61) | 4.55 (4.40) | 4.41 (3.61) | < 0.001 |
| Demographics/Health status | |||||||||
| Age, years | 66.5 (19.7) | 61.6 (19.6) | 57.2 (20.2) | 58.0 (18.2) | 66.5 (17.8) | 58.0 (19.9) | 73.5 (17.5) | 79.4 (16.6) | < 0.001 |
| Female, n (%) | 255 (58.8) | 172 (56.2) | 78 (65.0) | 24 (53.3) | 108 (55.1) | 42 (50.0) | 56 (51.9) | 16 (50.0) | 0.36 |
| PSI score | 75.7 (43.6) | 79.2 (46.2) | 64.6 (42.3) | 61.1 (45.3) | 87.7 (46.2) | 72.8 (52.8) | 117.2 (47.6) | 137.9 (53.5) | 0.001 |
| Charlson Index | 1.19 (1.30) | 1.28 (1.36) | 0.97 (0.99) | 1.00 (1.04) | 1.05 (1.19) | 1.15 (1.15) | 1.10 (1.23) | 1.34 (1.60) | 0.25 |
| Hospital stay | |||||||||
| Length of stay, days | 4.07 (3.40) | 5.92 (4.58) | 3.90 (3.38) | 2.42 (1.44) | 5.54 (4.84) | 4.01 (3.48) | 6.42 (5.08) | 9.50 (6.25) | < 0.001 |
| 30-day mortality§, n (%) | 15 (3.85) | 11 (4.09) | 0 (0.00) | 0 (0.00) | 14 (8.59) | 2 (2.74) | 25 (26.3) | 29 (100.0) | < 0.001 |
| Inpatient mortality, n (%) | 3 (0.70) | 3 (1.00) | 0 (0.00) | 0 (0.00) | 7 (3.57) | 1 (1.19) | 0 (0.00) | 31 (96.9) | < 0.001 |
| Total cost, $ | 6,210 (6,626) | 11,789 (14,319) | 6,967 (9588) | 3,700 (3,031) | 11,313 (14,907) | 7,908 (8,506) | 12,913 (14,408) | 24,860 (26,011) | < 0.001 |
BP blood pressure, MS return to baseline mental status, OI ability to feed by oral intake; RR respiratory rate, T temperature, HR heart rate, O2 blood oxygen saturation
*P values indicate tests of differences across cluster by ANOVA or Chi-square tests
†Rank order of stabilizations ranged from 1 to 7; 0 indicates stable on presentation; 8 indicates instability at discharge; 9 indicates not stabilized prior to inpatient death. Lower means indicate lower overall rank order of resolution for those indicators, which results from early stabilization. Indicators with means 5.0–7.0 have influence from late stabilization and/or persisting instabilities, and means > 7.0 indicate substantial influence from instabilities and inpatient mortality. Lower SDs indicate more homogeneous ranks among patients
‡These are the average orders of stabilization for patients in each cluster, based on the average ranks of stabilization of each indicator within each cluster
§Excludes University of New Mexico due to partial data unavailability