Original Research
Monday, November 13, 2023
01:00 PM–02:30 PM
Abstract
Introduction: Characterizing relationships among medication use in the intensive care unit (ICU), severity of illness, and mortality is an important next step in ICU prediction models.
Research Question or Hypothesis: The objective of this study was to explore the association between MRC-ICU at 24 hours and mortality and moreover whether the addition of MRC-ICU to baseline severity of illness models improves mortality prediction.
Study Design: In this observational cohort study, a random sample of 1,000 adults admitted =24 hours to the ICU were included.
Methods: The primary outcome of mortality was assessed via area under the receiver operating characteristic (AUROC) via regression modeling. Medication regimen complexity was evaluated at 24 hours using the MRC-ICU scoring tool. Baseline demographic features were collected and severity of illness was characterized using both the Acute Physiology and Chronic Health Evaluation (APACHE II) and the Sequential Organ Failure Assessment (SOFA) score.
Results: While univariate analysis showed increase in hospital mortality with increasing MRC-ICU, after controlling for baseline APACHE-II and SOFA score, the MRC-ICU score was associated with a 6% decrease in odds of hospital mortality (OR 0.94, 95% CI 0.90-0.99, p-value < 0.01).The highest AUROC achieved was 0.80, which included variables for severity of illness and medication regimen complexity.
Conclusion: Medication regimen complexity may be an important factor for incorporation into ICU prediction models as medications can serve as both independent risk factors for positive and negative ICU outcomes.
Presenting Author
Andrea Sikora Newsome PharmD, MSCR, BCCCP, FCCMAugusta University Medical Center/UGA College of Pharmacy
Authors
Mitchell Buckley Pharm.D., FASHP, FCCM, FCCP, BCCCP
Banner - University Medical Center Phoenix
David Murphy MD, PhD
Emory University
Brian Murray PharmD, BCCCP
UNC
XianYan Chen PhD
UGA
John Devlin PharmD, FCCP
Northeastern University
Tianyi Zhang n/a
UGA
Sandra Rowe PharmD, BCCCP
Oregon Health & Science University
Susan E. Smith PharmD, BCPS, BCCCP, FCCM
University of Georgia College of Pharmacy