Development and Evaluation of Risk Models to Predict Readmission or Death Following Discharge from an Adult General Systems Intensive Care Unit

Transitions of care from intensive care unit (ICU) to ward are high-risk periods of healthcare delivery associated with ICU readmission and post-ICU mortality. Evidence-based processes for transitions are crucial for improving outcomes. Validated prediction models that include consistently associated risk factors for ICU readmission or post-ICU mortality may help to improve these practices. This mixed-methods thesis was comprised of three distinct phases: 1) systematic review and meta-analysis; 2) development of prediction models for ICU Readmission and Post-ICU Mortality using two approaches (literature-derived coefficients, data-derived coefficients [Derivation Cohort]), 3) validation of the models in an external Validation Cohort. The models for ICU Readmission showed limited discriminative ability whereas the Post-ICU Mortality models were stronger. Developing prediction models using pooled measures of association is a feasible approach, producing similar results to more the traditional data-derived method. Additional investigation to further validate the findings is required.

Name thesis:degree_name

Master of Science (MSc)

Discipline thesis:degree_discipline

Community Health Sciences

Grantor dc:publisher.institution

Cumming School of Medicine

Year dc:date.issued

2018

Author dc:creator

• Boyd, Jamie

Advisor dc:contributor.advisor

• Stelfox, Henry Thomas

Committee members dc:contributor.committeemember

• James, Matthew T.
• Zuege, Danny J.

• critical care
• intensive care unit
• transitions of patient care
• prediction models
• readmission
• in-hospital mortality
• meta-analysis
• logistic regression

Statement dc:rights

• University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.

Language dc:language.iso

eng

DOI

http://dx.doi.org/10.11575/PRISM/32355

OAI identifier oai:identifier

oai:ucalgary.scholaris.ca:1880/107133