Key result
The Epic ICU mortality risk model was superior to the APACHE IV score for predicting hospital mortality (AUROC 89.7% vs 88.2%; P<.001).
Why the study?
The study was conducted to compare the predictive performance of Epic Systems Corporation's proprietary intensive care unit mortality risk model with that of the APACHE IV score.
Does the Epic IMRM predict ICU mortality better than the APACHE IV score in ICU patients?
Cohort (n=63,775)
No
Does the Epic IMRM predict ICU mortality better than the APACHE IV score in ICU patients?
The Epic IMRM demonstrated superior discrimination for ICU mortality compared to the APACHE IV score, offering an easily integrated predictive tool for hospitals using Epic software.
May support Epic IMRM integration where available; extends single-center validation but leaves generalizability open pending prospective studies.
Objective To compare the predictive performance of Epic Systems Corporation's proprietary intensive care unit (ICU) mortality risk model (IMRM) with that of the Acute Physiology and Chronic Health Evaluation (APACHE) IV score. Methods This is a retrospective cohort study of patients treated from January 1, 2008, through January 1, 2018. This single-center study was performed at Mayo Clinic (Rochester, MN), a tertiary care teaching and referral center. The primary outcome was death in the ICU. Discrimination of each risk model for hospital mortality was assessed by comparing area under the receiver operating characteristic curve (AUROC). Results The cohort mostly comprised older patients (median age, 64 years) and men (56.7%). The mortality rate of the cohort was 3.5% (2251 of 63,775 patients). The AUROC for mortality prediction was 89.7% (95% CI, 89.5% to 89.9%) for the IMRM, which was significantly greater than the AUROC of 88.2% (95% CI, 87.9% to 88.4%) for APACHE IV ( P <.001). Conclusion The IMRM was superior to the commonly used APACHE IV score and may be easily integrated into electronic health records at any hospital using Epic software.
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Tan et al. (2020) conducted a cohort in Intensive care unit (ICU) patients (n=63,775). Epic ICU mortality risk model (IMRM) vs. APACHE IV score was evaluated on Death in the ICU (p=<.001). The Epic ICU mortality risk model was superior to the APACHE IV score for predicting hospital mortality (AUROC 89.7% vs 88.2%; P<.001).
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