Results: We identified 5 RR escalation patterns among 918 CRI positive patients (Fig. 116).
Risk escalation patterns were not significantly associated with age, CCI or SDU LOS.
Objectives: To assess the association between risk escalation patterns and baseline demographics as well as length of stay (LOS).
We discovered distinct relative risk (RR) escalation patterns among 918 CRI positive patients during the 4 hours immediately before CRI onset, following methods in [1].
Introduction: We previously discovered that patients in step down units (SDUs) who developed cardiorespiratory instability (CRI) may follow several distinct risk escalation patterns based on a risk score derived from multi-parameter vital sign (VS) from bedside monitors.
Conclusions: There is potential "risk stratification value" of VS collected during initial hours of SDU stay in predicting the CRI risk escalation patterns later on, which may in turn predict hospital LOS.
The mean RR derived in the first 4-hours after admission is strongly associated with risk escalation patterns observed (p-value < 0.001), specifically, patients of "persistently high" type were more likely to have higher mean risk levels at SDU admission.
We then tested for association of RR escalation patterns with the mean risk levels during the first 4 post-SDU admission hours, and independently with demographics (age, Charlson Comorbidity Index [CCI]), and SDU and hospital LOS) using ANOVA at 0.05 significance level.
Our results also indicate that the body surface area-based dosing used in pediatric trials can make a difference in dose escalation/de-escalation patterns in the CRM compared to the cases where such variations are not taken into account in the calculations, even leading to different MTDs in some cases.
Although our estimates for the comparable cohorts are based on a different definition of escalation, the overall pattern is the same; i.e., a high proportion of dose increases was observed among patients on infliximab and a relatively low proportion among those on etanercept.
