Risk-adjusted Outcome Prediction Tool for Emergency Department Intensive Care Unit Patients

JI Program: Exploratory (Emergency Medicine)

Summary

Dedicated emergency department critical care units are well-established in China but novel to the U.S. The recent establishment of an emergency department Critical Care Center (EC3) at the main University Hospital of Michigan Medicine provides a unique opportunity for clinical research collaboration with the well-established Emergency Department Resuscitation Unit and Intensive Care Unit (ED-RU-ICU) at Peking University 3rd Hospital. Innovative strategies for early diagnosis and treatment of time-sensitive critical illness and injury could be co-developed and rapidly evaluated. However, a major challenge to collaborative multicenter research in emergency critical care is the lack of validated tools to risk-adjusted outcomes. The overall goal of this research collaboration is to develop a clinical research platform that will facilitate future multicenter interventional clinical trials in the emergency critical care setting.      

Outcome

  • Proposed enrollment numbers:1500 from each sit. Actual enrollment numbers: U-M: 3,543 and PKUHSC: 1,706.
  • Three PKUHSC visiting scholars shadowed in the EC3/ ED at Michigan Medicine in 2017 and 2018
  • Observed 30-day mortality in the study cohort was 14.3% (508/3543) for the U.S. population and 17.8% (303/1706) in the Chinese population (p= 0.0015).
  • Results were presented at two national critical care conferences in the U.S.:
    1. Joshua M. Glazer, Kyle J. Gunnerson, Richard P. Medlin, Steve L. Kronick, Robert W. Neumar, and Benjamin S. Bassin: PReDICT: Prognosticate Resuscitation Demands Integrating Computerized Triage, SAEM Annual Meeting, Academic Emergency Medicine, 23, Suppl. 1, S237, 2016.
    2. Joshua Glazer, Richard Medlin, Benjamin Bassin, Kyle Gunnerson: Existing Disease Severity Scoring Systems and Their Utility in an ED- ICU, 46th Annual Critical Care Congress, Honolulu, Hawaii, Critical Care Medicine, 44(12) Supplement 1, 356, 2016.

Publications

One collaborative manuscript was submitted in early June 2019 to the Journal of Critical Care Medicine (title: "Risk-adjusted Outcome Prediction Tool for Emergency Department Intensive Care Unit Patients".