Pediatr Crit Care Me
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To determine the relationship between PICU volume and severity-adjusted mortality in a large, national dataset. ⋯ For patients with low severity of illness, ICU volume is not associated with mortality. As patient severity of illness rises, higher volume units have higher severity of illness-adjusted mortality. This may be related to differences in quality of care, issues with unmeasured confounding, or calibration of existing severity of illness scores.
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Pediatr Crit Care Me · Jun 2016
Development of a Prediction Model of Early Acute Kidney Injury in Critically Ill Children Using Electronic Health Record Data.
Acute kidney injury is independently associated with poor outcomes in critically ill children. However, the main biomarker of acute kidney injury, serum creatinine, is a late marker of injury and can cause a delay in diagnosis. Our goal was to develop and validate a data-driven multivariable clinical prediction model of acute kidney injury in a general PICU using electronic health record data. ⋯ We developed and validated the Pediatric Early AKI Risk Score, a data-driven acute kidney injury clinical prediction model that has good discrimination and calibration in a general PICU population using only electronic health record data that is objective, available in real time during the first 12 hours of ICU care and generalizable across PICUs. This prediction model was designed to be implemented in the form of an automated clinical decision support system and could be used to guide preventive, therapeutic, and research strategies.
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Pediatr Crit Care Me · Jun 2016
Editorial CommentVolume-Outcome Relationships in Pediatric Intensive Care.