PeraHealth Insights

NEW STUDY: Rothman Index predicts SICU mortality and readmissions

Rothman Index predicts Surgical ICU bounce-back 24-hours before discharge… as well as likelihood of eventual discharge to home

Managing care transitions is a challenge for care teams making decisions about when to transfer patients into and out of various units as their conditions seem to improve or decline based on available information. The wrong transfer decisions can harm patients.

Predictive analytics can help.

The April 2019 edition of The Journal of Trauma and Acute Care Surgery includes the article,“Application of electronic medical record-derived analytics in critical care: Rothman Index predicts mortality and readmissions in surgical intensive care unit patients,” by Abdul Q. Alarhayem, MD, Mark T. Muir, MD, Donald J. Jenkins, MD, Basil A. Pruitt, MD, Brian J. Eastridge, MD, Maulik P. Purohit, MD, MPH, and Ramon F. Cestero, MD.

This study’s purpose was to assess the validity of Rothman Index scores in predicting surgical ICU (SICU) readmission rates and mortality.

Figure #2 from that paper shows Rothman Index scores for patients who were readmitted to the SICU within 48 hours vs. those who were not. Surgical ICU patients requiring readmission within 48 hours of transfer to a surgical floor have a significantly higher mortality and longer LOS, particularly in the elderly population.

The authors conclude:

  • “As an EMR-derived composite measure of a patient’s clinical condition, the Rothman Index may be a useful tool for evaluating patients before SICU transfer and can assist in identifying patients at higher risk for mortality and ICU readmission.”
  • “Earlier automated identification of higher-risk patients as determined by decreases in the Rothman Index has the potential to decrease the frequency of rapid-response calls and code events and may possibly offer a survival advantage.”

These results in mortality and readmissions are examples of the important intersection of clinical and financial efficiency needed for hospitals to perform in the value-based care environment.

The Rothman Index is an extensively validated patient acuity score derived from many data elements in the electronic medical record. It creates a picture of any patient’s condition over time – any age, any disease, any unit. Its unique use of nursing notes in addition to vitals and labs gives it the ability to detect patient deterioration hours or days earlier than existing scores and systems.

“This work adds to the more than 100 studies done by researchers across the country as they develop the understanding which allows clinicians using the Rothman Index to improve patient care… this is our passion.”

Michael Rothman, PhD, co-developer of the Rothman Index, and Chief Science Officer of PeraHealth, a software company that uses the Rothman Index to transform the clinical and financial efficiency of healthcare.

Download the case study: Shannon Skilled Nursing Facility Enhances Care Transitions and Lowers Readmission Rates.

Contact us for more information or a Rothman Index demonstration.