162 Hypercapnia Poster
162.1 Summary
- Non-Cognitive Predictors of Student Success:A Predictive Validity Comparison Between Domestic and International Students
- The causes, prevalence, and consequences of hypercapnic respiratory failure are not well described. EHR data could help.
- WHY? The gold-standard test (ABG showing PaCO2 > 45 mmHg) is unreliably obtained.
- WHAT HAS BEEN DONE?
- Prevalence ~ PE (150 per 100k/y)
- Readmission ≥ CHF (23%, 30d)
- Mortality ~ Cancer (~40% 1yr)
- .
- Yet, methods of identification select very different patients.
- COMPUTABLE PHENOTYPE: (operational case definition)
- Efficacy trial: homogeneity, severity important
- Epi; QI: sensitivity, representativeness
162.2 Slide outline
162.2.1 Slide 1
- Non-Cognitive Predictors of Student Success:A Predictive Validity Comparison Between Domestic and International Students
- The causes, prevalence, and consequences of hypercapnic respiratory failure are not well described. EHR data could help.
- WHY? The gold-standard test (ABG showing PaCO2 > 45 mmHg) is unreliably obtained.
- WHAT HAS BEEN DONE?
- Prevalence ~ PE (150 per 100k/y)
- Readmission ≥ CHF (23%, 30d)
- Mortality ~ Cancer (~40% 1yr)
- .
- Yet, methods of identification select very different patients.
- COMPUTABLE PHENOTYPE: (operational case definition)
- Efficacy trial: homogeneity, severity important
- Epi; QI: sensitivity, representativeness
- WHY IS THIS WORTH DOING?
- Obesity, Opiates, Multimorbidity ↑
- Common component causes? Unknown
- Evidence: RCTs only of select subsets
- Post-acute management?
- Disorganized processes of care
- Evidence needed to improve
- Wayne Richards BS
- Jeanette Brown MD PhD
- Ram Gouripeddi MBBS MS
- Krishna Sundar MD
- PRESENTER:
- Brian W Locke, MD
- Ruth L. Kirschstein National Research Service Award 5T32HL105321
- HOW CAN WE BETTER IDENTIFY PATIENTS WITH HYPERCAPNIA?
- Validate Traditional Data-Points
- ABG
- Group
- ICD
- NIV
- Age
- 62±18
- 65±16
- 62±17
- % Female
- 46%
- 51%
- 42%
- % white
- 66%
- 71%
- 65%
- % Black
- 18%
- 19%
- 17%
- BMI
- 30.4±8.3
- 33.1±10.3
- 29.1±8.2
- % with CHF
- 37%
- 30%
- % with COPD
- 31%
- 14%
- % Opiate UD
- 6%
- 3%
- % Sleep Apnea
- 23%
- 24%
- 10%
- 925,512 patients
- 70 Healthcare organizations since 2017.
- 20 gigabytes of data (billions of data points)
- METHODS:
- Principal Component Analysis
- Propose and Evaluate Computable Phenotype(s)
- Alzoubi et al. Electronics 2019 doi:10.3390/electronics8111235
162.3 Learning objectives
- Non-Cognitive Predictors of Student Success:A Predictive Validity Comparison Between Domestic and International Students
- The causes, prevalence, and consequences of hypercapnic respiratory failure are not well described. EHR data could help.
- WHY? The gold-standard test (ABG showing PaCO2 > 45 mmHg) is unreliably obtained.
- WHAT HAS BEEN DONE?
- Prevalence ~ PE (150 per 100k/y)
162.4 Bottom line / summary
- Non-Cognitive Predictors of Student Success:A Predictive Validity Comparison Between Domestic and International Students
- The causes, prevalence, and consequences of hypercapnic respiratory failure are not well described. EHR data could help.
- WHY? The gold-standard test (ABG showing PaCO2 > 45 mmHg) is unreliably obtained.
- WHAT HAS BEEN DONE?
- Prevalence ~ PE (150 per 100k/y)
162.5 Approach
- TODO: Outline the initial assessment or decision point.
- TODO: Outline the next diagnostic or management step.
- TODO: Outline follow-up or escalation criteria.
162.6 Red flags / when to escalate
- TODO: List red flags that require urgent escalation.
162.7 Common pitfalls
- TODO: Capture common errors or missed steps.
162.8 References
TODO: Add landmark references or guideline citations.