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Early prediction of hospital admission of emergency department patients.
- Source :
-
Emergency Medicine Australasia . Aug2023, Vol. 35 Issue 4, p572-588. 17p. - Publication Year :
- 2023
-
Abstract
- Objective: The early prediction of hospital admission is important to ED patient management. Using available electronic data, we aimed to develop a predictive model for hospital admission. Methods: We analysed all presentations to the ED of a tertiary referral centre over 7 years. To our knowledge, our data set of nearly 600 000 presentations is the largest reported. Using demographic, clinical, socioeconomic, triage, vital signs, pathology data and keywords in electronic notes, we trained a machine learning (ML) model with presentations from 2015 to 2020 and evaluated it on a held‐out data set from 2021 to mid‐2022. We assessed electronic medical records (EMRs) data at patient arrival (baseline), 30, 60, 120 and 240 min after ED presentation. Results: The training data set included 424 354 data points and the validation data set 53 403. We developed and trained a binary classifier to predict inpatient admission. On a held‐out test data set of 121 258 data points, we predicted admission with 86% accuracy within 30 min of ED presentation with 94% discrimination. All models for different time points from ED presentation produced an area under the receiver operating characteristic curve (AUC) ≥0.93 for admission overall, with sensitivity/specificity/F1‐scores of 0.83/0.90/0.84 for any inpatient admission at 30 min after presentation and 0.81/0.92/0.84 at baseline. The models retained lower but still high AUC levels when separated for short stay units or inpatient admissions. Conclusion: We combined available electronic data and ML technology to achieve excellent predictive performance for subsequent hospital admission. Such prediction may assist with patient flow. [ABSTRACT FROM AUTHOR]
- Subjects :
- *HOSPITAL emergency services
*HEALTH facilities
*PATIENTS
*TERTIARY care
*MACHINE learning
*MEDICAL care
*HOSPITAL admission & discharge
*HUMAN services programs
*WORKFLOW
*EMERGENCY medical services
*PREDICTION models
*ELECTRONIC health records
*PATIENT care
*RECEIVER operating characteristic curves
*SENSITIVITY & specificity (Statistics)
Subjects
Details
- Language :
- English
- ISSN :
- 17426731
- Volume :
- 35
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- Emergency Medicine Australasia
- Publication Type :
- Academic Journal
- Accession number :
- 164936003
- Full Text :
- https://doi.org/10.1111/1742-6723.14169