How UVA med school researchers predict patients' increased infection risk

Researchers at the University of Virginia School of Medicine in Charlottesville are using data science to help predict patients' increase in risk of infection and medical complications.

To determine when patients face a higher risk of complications, physician researchers evaluated cardiovascular diseases at different stages of life and developed predictive monitoring systems called the Heart Rate Observation System and Continuous Monitoring of Event Trajectories, or HeRO and CoMET.

HeRO produces a score that considers a baby's heart rate pattern as an indicator of an increased infection risk and health challenges in the NICU. CoMET uses a similar approach for older patients, where a predictive monitoring system puts different measurements of patients' well-being into a score that reflects their risk of experiencing complications while recovering in the surgical ICU. 

Researcher Joseph Randall Moorman, MD, professor of cardiovascular medicine at the UVA School of Medicine, emphasized the need for hospitals to use real-time predictive analytics during routine patient-monitoring processes.

"The practice of medicine is difficult," Dr. Moorman said. "Clinicians like myself miss things, and then patients get sick and deteriorate under our noses. … The [predictive monitoring] display is intended to use all of the data available to physicians and to synthesize for physicians the risk of patients getting sick."

Since it is often challenging to determine whether infants are ill, Dr. Moorman and colleagues monitored patients' heart rates and created the algorithms to predict the increase in risk that the patient may contract sepsis in the next few hours.

The results are displayed in a HeRO score at the patient's bedside so clinicians can easily see which babies to assess for other markers of infection.

In a trial of 3,000 babies to determine the effectiveness of the HeRO score, researchers found a decrease of more than 20 percent in mortality rate for infants who were monitored using the score. 

The success of monitoring in the trials reinforced the value of the HeRO score, which the NICU continues to use, said UVA pediatrics professor Karen Fairchild, MD. The researchers aim to improve the HeRO tool by adding respiratory and oxygen level analysis.

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