Table 3.
Factors of Adverse Outcomes by Admission Cohort.a
| Variable | Adjusted Odds Ratio (95% Confidence Interval) |
|
|---|---|---|
| Months 1 to 6 (n = 720) | Months 7 to 12 (n = 697) | |
| Demographics | ||
| Age | 1.05 (1.03-1.06) | 1.06 (1.04-1.08) |
| Recent discharge | 1.75 (1.02-3.01) | 2.20 (1.24-3.88) |
| Diagnostics | ||
| Corrected SIDa | 0.57 (0.33-0.96) | 1.88 (0.99-3.58) |
| Shock Index | 1.60 (0.99-2.59) | 1.68 (1.01-2.78) |
| Hypoxemia | 4.52 (2.76-7.38) | 4.45 (2.62-7.57) |
| CDS first alert activated | ||
| SIRS: HR & RR | 1.29 (0.66-2.51) | 2.11 (1.08-4.10) |
| SIRS: Temp & WBC | 0.61 (0.24-1.54) | 0.24 (0.05-1.13) |
| Sepsis: Perfusion | 1.02 (0.48-2.20) | 0.84 (0.37-1.93) |
| Sepsis: Cardiovascular | 1.39 (0.66-2.92) | 2.36 (1.07-5.22) |
| Sepsis: Renal | 2.44 (0.55-9.07) | 4.22 (1.10-16.18) |
| First alert patient location | ||
| Medicine | 1.88 (1.04-3.40) | 1.77 (0.94-3.31) |
| Critical care | 3.56 (1.79-7.07) | 3.31 (1.66-6.62) |
| C-statistic (95% confidence interval) | .80 (.76-.85) | .83 (.80-.87) |
Abbreviations: CDS, clinical decision support; HR, heart rate; RR, respiratory rate; SIDa, corrected apparent strong ion difference; SIRS, systemic inflammatory response syndrome; Temp, temperature; WBC, white blood cell count.
Multivariable Logistic Regression (MLR) model for each patient cohort; MLR model cohort months 7 to 12 constant = −7.987, model performance: Nagelkerke R2 = 0.31; Hosmer and Lemeshow test χ2 = 8.61, df = 8, P = .38; C-statistic = 0.83, 95% confidence interval (0.80 to 0.87). Age: one unit increase. Recent Discharge: patient discharged from hospital within 30 days of current hospitalization. Clinical Results: first diagnostics resulted at presentation include SIDa, Shock Index, and Hypoxemia. Patient Location at the patient’s first activated alert includes: Medicine (general medicine, oncology and pulmonary) and Critical Care units (general medicine, intensive nursing care unit, medical cardiac, and medical stroke and cardiac); ICU excluded.