Curation and description of a blood glucose management and nutritional support cohort using the eICU collaborative research database

Abstract

Freely available electronic medical record (EMR) data collections have transformed data science and observational research in critical care medicine. Descriptive characterisation of these data collections can aid in highlighting variation in clinical practice and patient outcomes across Intensive Care Units (ICUs). Glycaemic control and nutritional management are important aspects of patient management in the ICU. Blood glucose on admission has a well-known U-shaped relationship with mortality and morbidity, with both hypo- and hyper-glycemia being associated with poor patient outcomes. The importance of nutritional support has been highlighted in critical care guidelines. However, both areas have open research questions and highly variable clinical practices that observational data may help highlight and inform. To aid in this research, we curated a database of patients using the eICU collaborative research data (eICU-CRD), which we describe in the current paper, focusing on patient blood glucose, insulin therapy and enteral nutrition. The eICU-CRD is derived from a telehealth EMR covering 208 United States hospitals from 2014-2015. In addition to descriptive statistics and graphical analysis, we highlight any limitations in data quality. Our results are in line with previous research suggesting the eICU-CRD cohort is of lower illness severity than the average ICU patient cohort and so receive less invasive interventions. Examinations of data missingness revealed issues with medication orders and non-reporting of nutrition by several hospitals. Overall, with care around missingness we believe the eICU-CRD to be a valuable resource in evidence generation for critical care research.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study (via a PhD scholarship) was funded by UNSW Sydney, eHealth NSW and the Commonwealth Scientific and Industrial Research Organisation (CSIRO).

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

A waiver of consent that has previously been obtained from the Institutional Review Boards of MIT and BIDMC is applicable to these datasets due to their retrospective use of routinely collected EMR data. Institutional ethics for the research project was obtained from UNSW Sydney - HC220829.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

The data underlying this article are freely available at https://eicu-crd.mit.edu/ and can be accessed following completion of the required training and data usage agreements.

https://eicu-crd.mit.edu/

留言 (0)

沒有登入
gif