Exploring trajectories of emergency department visits using a laboratory-based indicator of serious illness. (March 2020)

• Record Type: Journal Article
• Authors: Ben-Assuli, Ofir; Padman, Rema; Shabtai, Itamar
• Other Names: Bian Jiang guest-editor.; Modave Francois guest-editor.
• Is Part Of: Health informatics journal. Volume 26:Number 1(2020)
• Page Start: 205
• Page End: 217
• Publication Date: 2020-03
• Subjects: creatinine levels -- emergency department visits -- electronic health record -- group-based trajectory model -- health information exchange -- risk stratification; Medical informatics -- Periodicals; 610.285
• DOI: 10.1177/1460458218824751
• Languages: English
• ISSNs: 1460-4582

Abstract

Repeated emergency department visits have become a serious challenge worldwide. Despite prior research indicating that laboratory results may provide early alerts about such patients on their upcoming adverse events, few studies have examined their role as a critical indicator of the stability of a patient's medical condition over time. We model and analyze the developmental trajectories of patients' creatinine levels, a key laboratory marker of serious illness, as a potential risk stratification mechanism across many emergency department visits. We apply group-based statistical methodology to electronic health record data of 70, 385 patients, with 3–15 emergency department visits, to identify and profile these trajectories for the entire population, for males and for females. Results reveal three distinct creatinine-based trajectory groups over time with significantly differing characteristics that may enable targeted interventions for each group. Future research will incorporate additional disease markers to identify longitudinal factors leading to repeated emergency department visits.