scholarly journals HEROES V‐V ‐ HEmorRhagic cOmplications in Veno‐Venous Extracorporeal life Support ‐ development and internal validation of multivariable prediction model in adult patients

2021 ◽  
Author(s):  
Anne Willers ◽  
Justyna Swol ◽  
Sander MJ van Kuijk ◽  
Hergen Buscher ◽  
Zoe McQuilten ◽  
...  
Keyword(s):  
Prediction Model ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Adult Patients ◽  
Internal Validation ◽  
Hemorrhagic Complications

Development and Validation of a Risk Prediction Model for Patients with COVID-19 Using Linked Population Health Data (Preprint)

2021 ◽  
Author(s):  
Nikolaos Mastellos ◽  
Richard Betteridge ◽  
Prasanth Peddaayyavarla ◽  
Andrew Moran ◽  
Jurgita Kaubryte ◽  
...  
Keyword(s):  
Health Care ◽  
Prediction Model ◽  
Population Health ◽  
Risk Prediction ◽  
Validation Cohort ◽  
Risk Prediction Model ◽  
Adult Patients ◽  
Internal Validation ◽  
Temporal Validation ◽  
Development And Validation

BACKGROUND The impact of the COVID-19 pandemic on health care utilisation and associated costs has been significant, with one in ten patients becoming severely ill and being admitted to hospital with serious complications during the first wave of the pandemic. Risk prediction models can help health care providers identify high-risk patients in their populations and intervene to improve health outcomes and reduce associated costs. OBJECTIVE To develop and validate a hospitalisation risk prediction model for adult patients with laboratory confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). METHODS The model was developed using pre-linked and standardised data of adult patients with laboratory confirmed SARS-CoV-2 from Cerner’s population health management platform (HealtheIntent®) in the London Borough of Lewisham. A total of 14,203 patients who tested positive for SARS-CoV-2 between 1st March 2020 and 28th February 2021 were included in the development and internal validation cohorts. A second temporal validation cohort covered the period between 1st March 2021 to 30th April 2021. The outcome variable was hospital admission in adult patients with laboratory confirmed SARS-CoV-2. A generalised linear model was used to train the model. The predictive performance of the model was assessed using the area under the receiver operator characteristic curve (ROC-AUC). RESULTS Overall, 14,203 patients were included. Of those, 9,755 (68.7%) were assigned to the development cohort, 2,438 (17.2%) to the internal validation cohort, and 2,010 (14.1%) to the temporal validation cohort. A total of 917 (9.4%) patients were admitted to hospital in the development cohort, 210 (8.6%) in the internal validation cohort, and a further 204 (10.1%) in the temporal validation cohort. The model had a ROC-AUC of 0.85 in both the development and validation cohorts. The most predictive factors were older age, male sex, Asian or Other ethnic minority background, obesity, chronic kidney disease, hypertension and diabetes. CONCLUSIONS The COVID-19 hospitalisation risk prediction model demonstrated very good performance and can be used to stratify risk in the Lewisham population to help providers reduce unnecessary hospital admissions and associated costs, improve patient outcomes, and target those at greatest risk to ensure full vaccination against SARS-CoV-2. Further research may examine the external validity of the model in other populations.

scholarly journals Therapeutic hypothermia in adult patients receiving extracorporeal life support: early results of a randomized controlled study

2016 ◽  
Vol 11 (1) ◽  
Author(s):  
Philip Y.K. Pang ◽  
Gillian H.L. Wee ◽  
Anne E.E. Hoo ◽  
Ismail Mohamed Tahir Sheriff ◽  
See Lim Lim ◽  
...  
Keyword(s):  
Therapeutic Hypothermia ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Adult Patients ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Early Results

Extracorporeal Life Support in Adult Patients

2019 ◽  
Vol 38 (3) ◽  
pp. 123-130
Author(s):  
Eva R. Kurniawati ◽  
Patrick W. Weerwind
Keyword(s):  
Life Support ◽  
Extracorporeal Life Support ◽  
Adult Patients

Conditions and procedures for in-hospital extracorporeal life support (ECLS) in cardiopulmonary resuscitation (CPR) of adult patients

Perfusion ◽  
2015 ◽  
Vol 31 (3) ◽  
pp. 182-188 ◽  
Author(s):  
Justyna Swol ◽  
Jan Belohlávek ◽  
Jonathan W. Haft ◽  
Shingo Ichiba ◽  
Roberto Lorusso ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Adult Patients

Oxygen Thresholds and Mortality During Extracorporeal Life Support in Adult Patients*

2017 ◽  
Vol 45 (12) ◽  
pp. 1997-2005 ◽  
Author(s):  
Laveena Munshi ◽  
Alex Kiss ◽  
Marcelo Cypel ◽  
Shaf Keshavjee ◽  
Niall D. Ferguson ◽  
...  
Keyword(s):  
Life Support ◽  
Extracorporeal Life Support ◽  
Adult Patients

External validation of the Pediatric Extracorporeal Membrane Oxygenation Prediction model for risk adjusting mortality

Perfusion ◽  
2020 ◽  
pp. 026765912095297
Author(s):  
David K Bailly ◽  
Jamie M Furlong-Dillard ◽  
Melissa Winder ◽  
Mark Lavering ◽  
Ryan P Barbaro ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Prediction Model ◽  
Goodness Of Fit ◽  
Pediatric Patients ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Characteristic Curve ◽  
External Validation ◽  
Group Model ◽  
Membrane Oxygenation

Introduction: The Pediatric Extracorporeal Membrane Oxygenation Prediction (PEP) model was created to provide risk stratification for all pediatric patients requiring extracorporeal life support (ECLS). Our purpose was to externally validate the model using contemporaneous cases submitted to the Extracorporeal Life Support Organization (ELSO) registry. Methods: This multicenter, retrospective analysis included pediatric patients (<19 years) during their initial ECLS run for all indications between January 2012 and September 2014. Median values from the BATE dataset for activated partial thromboplastin time and internationalized normalized ratio were used as surrogates as these were missing in the ELSO group. Model discrimination was evaluated using area under the receiver operating characteristic curve (AUC), and goodness-of-fit was evaluated using the Hosmer-Lemeshow test. Results: A total of 4,342 patients in the ELSO registry were compared to 514 subjects from the bleeding and thrombosis on extracorporeal membrane oxygenation (BATE) dataset used to develop the PEP model. Overall mortality was similar (42% ELSO vs. 45% BATE). The c-statistic after external validation decreased from 0.75 to 0.64 and model calibration decreases most in the highest risk deciles. Conclusion: Discrimination of the PEP model remains modest after external validation using the largest pediatric ECLS cohort. While the model overestimates mortality for the highest risk patients, it remains the only prediction model applicable to both neonates and pediatric patients who require ECLS for any indication and thus maintains potential for application in research and quality benchmarking.

scholarly journals Extracorporeal Life Support for 100 Adult Patients With Severe Respiratory Failure

1997 ◽  
Vol 226 (4) ◽  
pp. 544-566 ◽  
Author(s):  
Srinivas Kolla ◽  
Samir S. Awad ◽  
Preston B. Rich ◽  
Robert J. Schreiner ◽  
Ronald B. Hirschl ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Adult Patients ◽  
Severe Respiratory Failure

Bivalirudin Dosing Requirements in Adult Patients on Extracorporeal Life Support With or Without Continuous Renal Replacement Therapy

ASAIO Journal ◽  
2019 ◽  
Vol 65 (2) ◽  
pp. 134-138 ◽  
Author(s):  
Elizabeth A. Walker ◽  
A. Joshua Roberts ◽  
Erin L. Louie ◽  
William E. Dager
Keyword(s):  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Adult Patients
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