The simple observational critical care studies: estimations by students, nurses, and physicians of in-hospital and 6-month mortality

Abstract Background Prognostic assessments of the mortality of critically ill patients are frequently performed in daily clinical practice and provide prognostic guidance in treatment decisions. In contrast to several sophisticated tools, prognostic estimations made by healthcare providers are alway...

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Autores principales:	Eline G. M. Cox, Marisa Onrust, Madelon E. Vos, Wolter Paans, Willem Dieperink, Jacqueline Koeze, Iwan C. C. van der Horst, Renske Wiersema, SICS Study Group & SOCCS Student Team
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Critically ill patients Prognostic Estimations Students Nurses Physicians Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/071ed7a9099a410dabef1924224138de
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spelling	oai:doaj.org-article:071ed7a9099a410dabef1924224138de2021-11-21T12:02:49ZThe simple observational critical care studies: estimations by students, nurses, and physicians of in-hospital and 6-month mortality10.1186/s13054-021-03809-w1364-8535https://doaj.org/article/071ed7a9099a410dabef1924224138de2021-11-01T00:00:00Zhttps://doi.org/10.1186/s13054-021-03809-whttps://doaj.org/toc/1364-8535Abstract Background Prognostic assessments of the mortality of critically ill patients are frequently performed in daily clinical practice and provide prognostic guidance in treatment decisions. In contrast to several sophisticated tools, prognostic estimations made by healthcare providers are always available and accessible, are performed daily, and might have an additive value to guide clinical decision-making. The aim of this study was to evaluate the accuracy of students’, nurses’, and physicians’ estimations and the association of their combined estimations with in-hospital mortality and 6-month follow-up. Methods The Simple Observational Critical Care Studies is a prospective observational single-center study in a tertiary teaching hospital in the Netherlands. All patients acutely admitted to the intensive care unit were included. Within 3 h of admission to the intensive care unit, a medical or nursing student, a nurse, and a physician independently predicted in-hospital and 6-month mortality. Logistic regression was used to assess the associations between predictions and the actual outcome; the area under the receiver operating characteristics (AUROC) was calculated to estimate the discriminative accuracy of the students, nurses, and physicians. Results In 827 out of 1,010 patients, in-hospital mortality rates were predicted to be 11%, 15%, and 17% by medical students, nurses, and physicians, respectively. The estimations of students, nurses, and physicians were all associated with in-hospital mortality (OR 5.8, 95% CI [3.7, 9.2], OR 4.7, 95% CI [3.0, 7.3], and OR 7.7 95% CI [4.7, 12.8], respectively). Discriminative accuracy was moderate for all students, nurses, and physicians (between 0.58 and 0.68). When more estimations were of non-survival, the odds of non-survival increased (OR 2.4 95% CI [1.9, 3.1]) per additional estimate, AUROC 0.70 (0.65, 0.76). For 6-month mortality predictions, similar results were observed. Conclusions Based on the initial examination, students, nurses, and physicians can only moderately predict in-hospital and 6-month mortality in critically ill patients. Combined estimations led to more accurate predictions and may serve as an example of the benefit of multidisciplinary clinical care and future research efforts.Eline G. M. CoxMarisa OnrustMadelon E. VosWolter PaansWillem DieperinkJacqueline KoezeIwan C. C. van der HorstRenske WiersemaSICS Study Group & SOCCS Student TeamBMCarticleCritically ill patientsPrognosticEstimationsStudentsNursesPhysiciansMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENCritical Care, Vol 25, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Critically ill patients Prognostic Estimations Students Nurses Physicians Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Critically ill patients Prognostic Estimations Students Nurses Physicians Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Eline G. M. Cox Marisa Onrust Madelon E. Vos Wolter Paans Willem Dieperink Jacqueline Koeze Iwan C. C. van der Horst Renske Wiersema SICS Study Group & SOCCS Student Team The simple observational critical care studies: estimations by students, nurses, and physicians of in-hospital and 6-month mortality
description	Abstract Background Prognostic assessments of the mortality of critically ill patients are frequently performed in daily clinical practice and provide prognostic guidance in treatment decisions. In contrast to several sophisticated tools, prognostic estimations made by healthcare providers are always available and accessible, are performed daily, and might have an additive value to guide clinical decision-making. The aim of this study was to evaluate the accuracy of students’, nurses’, and physicians’ estimations and the association of their combined estimations with in-hospital mortality and 6-month follow-up. Methods The Simple Observational Critical Care Studies is a prospective observational single-center study in a tertiary teaching hospital in the Netherlands. All patients acutely admitted to the intensive care unit were included. Within 3 h of admission to the intensive care unit, a medical or nursing student, a nurse, and a physician independently predicted in-hospital and 6-month mortality. Logistic regression was used to assess the associations between predictions and the actual outcome; the area under the receiver operating characteristics (AUROC) was calculated to estimate the discriminative accuracy of the students, nurses, and physicians. Results In 827 out of 1,010 patients, in-hospital mortality rates were predicted to be 11%, 15%, and 17% by medical students, nurses, and physicians, respectively. The estimations of students, nurses, and physicians were all associated with in-hospital mortality (OR 5.8, 95% CI [3.7, 9.2], OR 4.7, 95% CI [3.0, 7.3], and OR 7.7 95% CI [4.7, 12.8], respectively). Discriminative accuracy was moderate for all students, nurses, and physicians (between 0.58 and 0.68). When more estimations were of non-survival, the odds of non-survival increased (OR 2.4 95% CI [1.9, 3.1]) per additional estimate, AUROC 0.70 (0.65, 0.76). For 6-month mortality predictions, similar results were observed. Conclusions Based on the initial examination, students, nurses, and physicians can only moderately predict in-hospital and 6-month mortality in critically ill patients. Combined estimations led to more accurate predictions and may serve as an example of the benefit of multidisciplinary clinical care and future research efforts.
format	article
author	Eline G. M. Cox Marisa Onrust Madelon E. Vos Wolter Paans Willem Dieperink Jacqueline Koeze Iwan C. C. van der Horst Renske Wiersema SICS Study Group & SOCCS Student Team
author_facet	Eline G. M. Cox Marisa Onrust Madelon E. Vos Wolter Paans Willem Dieperink Jacqueline Koeze Iwan C. C. van der Horst Renske Wiersema SICS Study Group & SOCCS Student Team
author_sort	Eline G. M. Cox
title	The simple observational critical care studies: estimations by students, nurses, and physicians of in-hospital and 6-month mortality
title_short	The simple observational critical care studies: estimations by students, nurses, and physicians of in-hospital and 6-month mortality
title_full	The simple observational critical care studies: estimations by students, nurses, and physicians of in-hospital and 6-month mortality
title_fullStr	The simple observational critical care studies: estimations by students, nurses, and physicians of in-hospital and 6-month mortality
title_full_unstemmed	The simple observational critical care studies: estimations by students, nurses, and physicians of in-hospital and 6-month mortality
title_sort	simple observational critical care studies: estimations by students, nurses, and physicians of in-hospital and 6-month mortality
publisher	BMC
publishDate	2021
url	https://doaj.org/article/071ed7a9099a410dabef1924224138de
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The simple observational critical care studies: estimations by students, nurses, and physicians of in-hospital and 6-month mortality

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