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Post-Intensive Care Risk-adjusted and Monitoring (PICRAM)

Research Summary

Researchers: Dr Jonathan Burgess, Prof. Lionel Tarassenko

Clinical collaborators: Dr Duncan Young, Dr Peter Watkinson (Intensive Care Unit, John Radcliffe Hospital)

Funding: Wellcome Trust and Department of Health (Health Innovation Challenge Fund)

One tenth of the 85,000 patients discharged annually from UK Intensive Care Units (ICUs) recovering from their acute illness, die before leaving hospital. The PICRAM study is a clinical study to develop and undertake proof-of-concept testing of a wireless electronic monitoring system built around wearable sensors to analyse the vital signs of patients who have been discharged from an Intensive Care Unit. The development work is taking place in Oxford and the clinical testing both in Oxford and Reading.

The hypothesis is that an automated, population-calibrated, multi-modal alerting system will better identify patients at risk of clinical deterioration than standard care. The aim is to design and implement a data fusion system to integrate the vital sign data from the wearable sensors and avoid or decrease the severity of clinical deterioration by appropriate early warning. The data fusion model will be tuned for each patient according to the physiological data acquired for that patient during the last three days on the ICU prior to discharge to the ward. This should lead to a clinically significant reduction in the number of patient deaths occurring in hospital after discharge from ICU.

In systematic literature reviews, we have undertaken a review of (i) the factors associated with ICU readmission; (ii) the factors associated with post-ICU mortality. The results from these literature reviews have given us a list of candidate variables for our data fusion models of post-ICU risk of mortality.