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Automated APACHE II and SOFA score calculation using real-world electronic medical record data in a single center

The integration of illness severity and organ dysfunction scores into clinical practice, including the APACHE II and SOFA scores, has been challenging due to constraints associated to manual score calculation. With electronic medical records (EMR), score calculation automation using data extraction...

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Autores principales: Mutchmore, Alexandre, Lamontagne, François, Chassé, Michaël, Moore, Lynne, Mayette, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10113718/
https://www.ncbi.nlm.nih.gov/pubmed/37074523
http://dx.doi.org/10.1007/s10877-023-01010-8
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author Mutchmore, Alexandre
Lamontagne, François
Chassé, Michaël
Moore, Lynne
Mayette, Michael
author_facet Mutchmore, Alexandre
Lamontagne, François
Chassé, Michaël
Moore, Lynne
Mayette, Michael
author_sort Mutchmore, Alexandre
collection PubMed
description The integration of illness severity and organ dysfunction scores into clinical practice, including the APACHE II and SOFA scores, has been challenging due to constraints associated to manual score calculation. With electronic medical records (EMR), score calculation automation using data extraction scripts has emerged as a solution. We aimed to demonstrate that APACHE II and SOFA scores calculated with an automated EMR-based data extraction script predict important clinical endpoints. In this retrospective cohort study, every adult patient admitted to one of our three ICUs, between July 1, 2019, and December 31, 2020, were enrolled. For every patient, an automated ICU admission APACHE II score was calculated using EMR data and minimal clinician input. Fully automated daily SOFA scores were calculated for every patient. 4 794 ICU admissions met our selection criteria. Of these ICU admissions, 522 deaths were recorded (10.9% in-hospital mortality rate). The automated APACHE II was discriminant for in-hospital mortality (AU-ROC = 0.83 (95% CI 0.81–0.85)). We observed an association between the APACHE II score and ICU LOS, with a statistically significant mean increase of 1.1 days of ICU LOS (1.1 [1–1.2]; p =  < .0001) for each 10 units increase in APACHE score. SOFA score curves did not discrimate significantly between survivors and non-survivors. A partially automated APACHE II score, calculated with real-world EMR data using an extraction script, is associated with in-hospital mortality risk. The automated APACHE II score could potentially constitute an acceptable surrogate of ICU acuity to be used in resource allocation and triaging, especially in time of high demand for ICU beds.
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spelling pubmed-101137182023-04-20 Automated APACHE II and SOFA score calculation using real-world electronic medical record data in a single center Mutchmore, Alexandre Lamontagne, François Chassé, Michaël Moore, Lynne Mayette, Michael J Clin Monit Comput Original Research The integration of illness severity and organ dysfunction scores into clinical practice, including the APACHE II and SOFA scores, has been challenging due to constraints associated to manual score calculation. With electronic medical records (EMR), score calculation automation using data extraction scripts has emerged as a solution. We aimed to demonstrate that APACHE II and SOFA scores calculated with an automated EMR-based data extraction script predict important clinical endpoints. In this retrospective cohort study, every adult patient admitted to one of our three ICUs, between July 1, 2019, and December 31, 2020, were enrolled. For every patient, an automated ICU admission APACHE II score was calculated using EMR data and minimal clinician input. Fully automated daily SOFA scores were calculated for every patient. 4 794 ICU admissions met our selection criteria. Of these ICU admissions, 522 deaths were recorded (10.9% in-hospital mortality rate). The automated APACHE II was discriminant for in-hospital mortality (AU-ROC = 0.83 (95% CI 0.81–0.85)). We observed an association between the APACHE II score and ICU LOS, with a statistically significant mean increase of 1.1 days of ICU LOS (1.1 [1–1.2]; p =  < .0001) for each 10 units increase in APACHE score. SOFA score curves did not discrimate significantly between survivors and non-survivors. A partially automated APACHE II score, calculated with real-world EMR data using an extraction script, is associated with in-hospital mortality risk. The automated APACHE II score could potentially constitute an acceptable surrogate of ICU acuity to be used in resource allocation and triaging, especially in time of high demand for ICU beds. Springer Netherlands 2023-04-19 /pmc/articles/PMC10113718/ /pubmed/37074523 http://dx.doi.org/10.1007/s10877-023-01010-8 Text en © The Author(s), under exclusive licence to Springer Nature B.V. 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Research
Mutchmore, Alexandre
Lamontagne, François
Chassé, Michaël
Moore, Lynne
Mayette, Michael
Automated APACHE II and SOFA score calculation using real-world electronic medical record data in a single center
title Automated APACHE II and SOFA score calculation using real-world electronic medical record data in a single center
title_full Automated APACHE II and SOFA score calculation using real-world electronic medical record data in a single center
title_fullStr Automated APACHE II and SOFA score calculation using real-world electronic medical record data in a single center
title_full_unstemmed Automated APACHE II and SOFA score calculation using real-world electronic medical record data in a single center
title_short Automated APACHE II and SOFA score calculation using real-world electronic medical record data in a single center
title_sort automated apache ii and sofa score calculation using real-world electronic medical record data in a single center
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10113718/
https://www.ncbi.nlm.nih.gov/pubmed/37074523
http://dx.doi.org/10.1007/s10877-023-01010-8
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