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Title: Development and Validation of the Medical Emergency Team-Risk Prediction Model for Clinical Deterioration in Acute Hospital Patients, at Time of an Emergency Admission.
Austin Authors: Allen, Joshua;Currey, Judy;Jones, Daryl A ;Considine, Julie;Orellana, Liliana
Affiliation: Deakin University, School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Geelong, VIC, Australia..
DEPM Monash University, Level 6 The Alfred Centre (Alfred Hospital), Melbourne, VIC, Australia..
Surgery (University of Melbourne)
Centre for Quality and Patient Safety Research-Eastern Health Partnership, VIC, Australia..
Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC, Australia..
Intensive Care
Issue Date: 22-Jul-2022
Date: 2022
Publication information: Critical care medicine 2022; online first: 22 July
Abstract: To develop and validate a prediction model to estimate the risk of Medical Emergency Team (MET) review, within 48 hours of an emergency admission, using information routinely available at the time of hospital admission. Development and validation of a multivariable risk model using prospectively collected data. Transparent Reporting of a multivariable model for Individual Prognosis Or Diagnosis recommendations were followed to develop and report the prediction model. A 560-bed teaching hospital, with a 22-bed ICU and 24-hour Emergency Department in Melbourne, Australia. A total of 45,170 emergency admissions of 30,064 adult patients (≥18 yr), with an inpatient length of stay greater than 24 hours, admitted under acute medical or surgical hospital services between 2015 and 2017. The outcome was MET review within 48 hours of emergency admission. Thirty candidate variables were selected from a routinely collected hospital dataset based on their availability to clinicians at the time of admission. The final model included nine variables: age; comorbid alcohol-related behavioral diagnosis; history of heart failure, chronic obstructive pulmonary disease (COPD), or renal disease; admitted from residential care; Charlson Comorbidity Index score 1 or 2, or 3+; at least one planned and one emergency admission in the last year; and admission diagnosis and one interaction (past history of COPD × admission diagnosis). The discrimination of the model was comparable in the training (C-statistics 0.82; 95% CI, 0.81-0.83) and the validation set (0.81; 0.80-0.83). Calibration was reasonable for training and validation sets. Using only nine predictor variables available to clinicians at the time of admission, the MET-risk model can predict the risk of MET review during the first 48 hours of an emergency admission. Model utility in improving patient outcomes requires further investigation.
DOI: 10.1097/CCM.0000000000005621
ORCID: 0000-0002-6446-3595
Journal: Critical care medicine
PubMed URL: 35866655
PubMed URL:
Type: Journal Article
Appears in Collections:Journal articles

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