Abstract 13937: Electrocardiography-Derived Respiratory Rate Detects Clinical Deterioration in Acute Care Patients With Cardiovascular Disease

Introduction: Clinical deterioration resulting in ICU transfer occurs in 4 to 5 of every 100 acute care admissions. Early Warning Scores (EWS) identify high risk patients, but rely on intermittent assessments. Continuous ECG not only provides heart rate (HR) and rhythm, but can also estimate respiratory rate (RR). Hypothesis: Continuous ECG data improves the predictive validity of EWS prior to acute deterioration leading to ICU transfer or unanticipated death. Methods: Among floor patients admitted with continuous ECG, we identified those with deterioration resulting in ICU transfer or unanticipated death. We analyzed 60 patient-years of ECG data and applied previously validated methodologies for detection of atrial fibrillation (AF) and estimation of RR. We evaluated the predictive validity of common EWS and compared them to models that incorporate ECG data. We excluded observations after DNR/DNI orders or transitions to comfort care. We calculated the fold change in mortality, and the predictive validit...