Table 2 Univariate predictors of RED events (N= 23,127 patient days)
Variable | Derivation | Events # (%) | Odds Ratio (95% CI) | p |
|---|---|---|---|---|
RED events a | 298 (1.3) | |||
age > 54 | 9,217 (39.9) | 145 (1.6) | 1.4 (1.14 - 1.81) | 0.002 |
Vitals, N(%) | ||||
Temperature (°F) | ||||
≤99.5 (ref.) | 20,157 (87.2) | 229 (1.1) | -- | -- |
>99.5 | 2,970 (12.8) | 69 (2.3) | 2.1 (1.58 - 2.72) | <0.001 |
Systolic Blood Pressure (mm Hg) | ||||
≤125 (ref.) | 7,122 (30.8) | 77 (1.1) | -- | -- |
>125 | 16,005 (69.2) | 221 (1.4) | 1.3 (0.99 - 1.66) | 0.063 |
Respirations per minute | ||||
≤24 (ref.) | 21,713 (93.9) | 192 (0.9) | -- | -- |
>24 | 1,414 (6.1) | 106 (7.5) | 9.1 (7.12 - 11.59) | <0.001 |
Pulse per minute | ||||
≤134 (ref.) | 22,464 (97.1) | 240 (1.1) | -- | -- |
>134 | 663 (2.9) | 58 (8.8) | 8.9 (6.59 - 11.96) | <0.001 |
Diastolic Blood Pressure (mm Hg) | ||||
≤120 (ref.) | 22,507 (97.3) | 265 (1.2) | -- | -- |
>120 | 620 (2.7) | 33 (5.3) | 4.7 (3.26 - 6.84) | <0.001 |
spO2 (%) | ||||
≤86 | 319 (1.4) | 25 (7.8) | 7.0 (4.59 - 10.74) | <0.001 |
>86 (ref.) | 22,808 (98.6) | 273 (1.2) | -- | -- |
Laboratory, N(%) | ||||
Platelets (103 cells/mm3) | ||||
<100 | 1959 (8.5) | 32 (1.6) | 1.3 (0.90 - 1.89) | 0.158 |
≥100 (ref.) | 21,168 (91.5) | 266 (1.3) | -- | -- |
Potassium (mEq/L) | ||||
≤2.9 | 155 (0.7) | 9 (5.8) | 5.4 (2.74 - 10.76) | <0.001 |
2.9 - 5.1 (ref.) | 21,811 (94.3) | 245 (1.1) | -- | -- |
>5.1 | 1,161 (5.0) | 44 (3.8) | 3.5 (2.50 - 4.81) | <0.001 |
Glucose (mg/dL) | ||||
≤250 (ref.) | 22,219 (96.0) | 276 (1.2) | -- | -- |
250 – 600 | 825 (3.6) | 17 (2.1) | 1.7 (1.02 - 2.74) | 0.042 |
>600 | 83 (0.4) | 5 (6.0) | 5.1 (2.05 - 12.69) | <0.001 |
Hematocrit (g/dL) | ||||
≤48 (ref.) | 22,925 (99.1) | 288 (1.3) | -- | -- |
> 48 | 202 (0.9) | 10 (5.0) | 4.1 (2.15 - 7.81) | <0.001 |
Creatinine | ||||
≤1.5 (ref.) | 17,937 (77.6) | 201 (1.1) | -- | -- |
>1.5 | 5,190 (22.4) | 97 (1.9) | 1.7 (1.32 - 2.15) | <0.001 |
White Blood Cell Count (103 cells/mm3) | ||||
≤11 (ref.) | 19,225 (83.1) | 204 (1.1) | -- | -- |
>11 | 3,902 (16.9) | 94 (2.4) | 2.3 (1.80 - 2.95) | <0.001 |
Total Bilirubin (mg/dL) | ||||
≤1.7 (ref.) | 22,172 (95.9) | 271 (1.2) | -- | -- |
>1.7 | 955 (4.1) | 27 (2.8) | 2.4 (1.57 - 3.51) | <0.001 |
Sodium (mEq/L) | ||||
≤128 | 983 (4.2) | 29 (3.0) | 2.5 (1.69 - 3.69) | <0.001 |
128 - 143 (ref.) | 21,808 (94.3) | 262 (1.2) | -- | -- |
>143 | 336 (1.5) | 7 (2.1) | 1.7 (0.82 - 3.74) | 0.148 |
pH | ||||
≤7.22 | 53 (0.2) | 11 (20.8) | 20.8 (10.60 - 40.80) | <0.001 |
>7.22 (ref.) | 23,074 (99.8) | 287 (1.2) | -- | -- |
pCO2 (mm Hg) | ||||
≤22 | 78 (0.3) | 12 (15.4) | 14.8 (7.89 - 27.62) | <0.001 |
22 - 70 (ref.) | 23,020 (99.5) | 280 (1.2) | -- | -- |
>70 | 29 (0.2) | 6 (20.7) | 21.2 (8.56 - 52.43) | <0.001 |
AST (U/L) | ||||
≤250 (ref.) | 22,826 (98.7) | 279 (1.2) | -- | -- |
>250 | 301 (1.3) | 19 (6.3) | 5.4 (3.37 - 8.79) | <0.001 |
Anion Gap | ||||
≤16 (ref.) | 21,791 (94.2) | 236 (1.1) | -- | -- |
>16 | 1,336 (5.8) | 62 (4.6) | 4.4 (3.34 - 5.91) | <0.001 |
Albumin (g/dL) | ||||
< 3.5 | 2,779 (12.0) | 54 (1.9) | 1.6 (1.21 - 2.20) | 0.001 |
≥3.5 (ref.) | 20,348 (88.0) | 244 (1.2) | -- | -- |
B-type natriuretic peptide (pg/mL) | ||||
≤100 (ref.) | 21,803 (94.3) | 257 (1.2) | -- | -- |
>100 | 1,324 (5.7) | 41 (3.1) | 2.7 (1.92 - 3.74) | <0.001 |
Thyroid Stimulating Hormone (μIU/mL) | ||||
≤0.4 | 60 (0.3) | 3 (5.0) | 4.1 (1.27 - 13.10) | 0.018 |
0.4 - 5.4 | 610 (2.6) | 7 (1.2) | 0.9 (0.42 - 1.91) | 0.784 |
>5.4 | 83 (0.4) | 3 (3.6) | 2.9 (0.91 - 9.26) | 0.071 |
Not measured (ref.) | 22,374 (96.7) | 285 (1.3) | -- | -- |
Estimated glomerular filtration rate (mL/min/1.73 m2) | ||||
≤30 | 3,009 (13.0) | 57 (1.9) | 1.6 (1.19 - 2.13) | 0.002 |
>30 (ref.) | 20,118 (87.0) | 241 (1.2) | -- | -- |
Physician Orders, N(%) | ||||
Bilevel positive airway pressure | 122 (0.5) | 11 (9.0) | 7.8 (4.18 - 14.73) | <0.001 |
Arterial Blood Gas | 1,436 (6.2) | 104 (7.2) | 8.7 (6.77 - 11.05) | <0.001 |
Troponin I | 3,725 (16.1) | 130 (3.5) | 4.1 (3.28 - 5.22) | <0.001 |
Electrocardiogram | 4,996 (21.6) | 183 (3.7) | 6.0 (4.71 - 7.54) | <0.001 |
Electroencephalogram | 87 (0.4) | 1 (1.2) | 0.9 (0.12 - 6.41) | 0.908 |
Telemetry | 1,765 (7.6) | 36 (2.0) | 1.7 (1.18 - 2.38) | 0.004 |
Stat order # 1 b | 1,704 (7.4) | 45 (2.6) | 2.3 (1.65 - 3.13) | <0.001 |
Stat order # 2 c | 2,476 (10.7) | 70 (2.8) | 2.6 (1.99 - 3.42) | <0.001 |
Administered Medications, N(%) | ||||
Institute of Safe Medication Practice High Alert Medication d | 9,257 (40.0) | 162 (1.8) | 1.8 (1.43 - 2.26) | <0.001 |
Systemic Steroids e | 758 (3.3) | 13 (1.7) | 1.4 (0.77 - 2.37) | 0.292 |
Sodium Bicarbonate | 423 (1.8) | 16 (3.8) | 3.1 (1.87 - 5.22) | <0.001 |
Lactulose or Rifaxamin | 535 (2.3) | 12 (2.2) | 1.8 (1.00 - 3.21) | 0.051 |
Antidote medication f | 308 (1.3) | 14 (4.6) | 3.8 (2.18 - 6.54) | <0.001 |
More than one nephrotoxic agent taken concurrently g | 3,580 (15.5) | 60 (1.7) | 1.4 (1.04 - 1.84) | 0.026 |
More than one antibiotic agent taken concurrently h | 2,549 (45.3) | 46 (1.8) | 1.5 (1.08 - 2.04) | 0.015 |
Intravenous fluid bolus | 1,270 (5.5) | 55 (4.3) | 4.0 (2.99 - 5.43) | <0.001 |
Stat acute coronary syndrome medications i | 2,436 (10.5) | 43 (1.8) | 1.4 (1.04 - 1.99) | 0.028 |
Stat seizure abatement medications j | 1,069 (4.6) | 31 (2.9) | 2.4 (1.67 - 3.55) | <0.001 |
Summary Variables | ||||
MEWS, Mean (SD) k | 2.28 (1.5) | 1.6 (1.54 - 1.70) | <0.001 | |
Level of Consciousness | ||||
0 – Alert | 7,580 (32.8) | 156 (2.1) | 3.1 (2.41 - 4.00) | <0.001 |
1 – Responds to voice/new confusion/restlessness | 543 (2.3) | 23 (4.2) | 6.5 (4.12 - 10.37) | <0.001 |
2 – Responds to pain | 102 (0.4) | 6 (5.9) | 9.2 (3.95 - 21.55) | <0.001 |
3 – Unresponsive | 32 (0.1) | 13 (40.6) | 101.1 (48.59 - 210.20) | <0.001 |
Not measured (ref.) | 14,870 (64.3) | 100 (0.7) | -- | -- |
High Risk Floor Assignment, N(%) l | 2,369 (10.2) | 158 (6.7) | 10.5 (8.35 - 13.27) | <0.001 |