Key result
Clinical instability, measured by maximum mortality risk increase (11.1-16.1% in deaths vs <0.1% in survivors), was significantly greater in non-survivors (P<0.001).
Why the study?
To test the hypothesis that within-patient clinical instability measured by deterioration and improvement in mortality risk over 3-, 6-, 9-, and 12-hour intervals indicates increasing severity of illness.
Does within-patient clinical instability measured by mortality risk changes indicate increasing severity of illness in PICU and cardiac ICU patients?
Cohort (n=8,399)
No
Does within-patient clinical instability measured by mortality risk changes indicate increasing severity of illness in PICU and cardiac ICU patients?
Within-patient clinical instability, quantified by changes in a machine learning mortality risk score, is significantly higher in non-survivors and serves as a reliable indicator of illness severity in pediatric ICU patients.
May flag rising severity in pediatric ICU; hypothesis-generating for real-time monitoring before practice change.
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Pollack et al. (2023) conducted a cohort in Critical illness in pediatric patients (n=8,399). Clinical instability (within-patient changes in mortality risk) vs. Clinical stability was evaluated on Within-patient maximum risk increase and decrease (clinical deterioration and improvement) (p=<0.001). Clinical instability, measured by maximum mortality risk increase (11.1-16.1% in deaths vs <0.1% in survivors), was significantly greater in non-survivors (P<0.001).
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