Faculty Collaboration Database

Predicting burn patient mortality with electronic medical records. Surgery 2018 Oct;164(4):839-847

Date

09/04/2018

Pubmed ID

30174140

DOI

10.1016/j.surg.2018.07.010

Scopus ID

2-s2.0-85052759336 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

BACKGROUND: Although there exists robust literature on mortality-associated factors in burn patients, it is not known how electronic medical records affect outcomes. Using burn injury as a surgical care model of information and communication, we hypothesized that functionality and interoperability of the electronic medical record could serve as determinants of outcome.

METHODS: We used the state inpatient databases for New York, Washington, California, and Florida for the years 2009 and 2010 for all states, with the additional years of 2012 and 2013 for New York (n = 6,002), and the respective data from the American Hospital Association Information Technology survey. Using International Classification of Diseases, Ninth Revision, codes, we included burn patients and characterized total body surface area burned. We summed the binary answers to questions 1 and 2 and question 3 from the American Hospital Association Information Technology survey to make continuous functionality and interoperability scores. Mortality was predicted using extreme gradient boosting in Python.

RESULTS: In each state in which our models had an accuracy and area under the curve of more than 0.90, electronic medical record functionality but not interoperability was a significant predictor in New York, California, and Florida. Important predictors in each state were, age, duration of stay, total body surface area burned/severity, and total charges. Electronic medical record functionality was more important than all comorbidities except for coagulopathies and electrolyte disorders. Higher functionality scores were associated with mortality (P < .01).

CONCLUSION: Our data support our hypothesis that electronic medical records may be associated with mortality in burn patients; however, electronic medical records are not having the intended impact on outcomes, and further research needs to elucidate exactly how electronic medical records are being used in clinical settings.

Author List

Cheung M, Cobb AN, Kuo PC

Author

Adrienne Cobb MD Assistant Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Burns
Cross-Sectional Studies
Databases, Factual
Electronic Health Records
Female
Hospital Mortality
Humans
Male
Middle Aged
Retrospective Studies
Risk Assessment
Risk Factors
United States