mit-lcp / vancomycin-nephrotoxicity Goto Github PK
View Code? Open in Web Editor NEWStudy in eICU-CRD about vancomycin and associated nephrotoxicity
Study in eICU-CRD about vancomycin and associated nephrotoxicity
The routes in eICU-CRD that we decided on during the project do not exhaustively cover the routes in the full version of eICU. e.g. running this query on hera:
WITH ce AS
(
SELECT
patientunitstayid,
CASE
WHEN drugstopoffset = 0 THEN drugstartoffset
WHEN drugstartoffset <= drugstopoffset THEN drugstartoffset
WHEN drugstopoffset < drugstartoffset THEN drugstopoffset
END AS drugstartoffset,
CASE
WHEN drugstopoffset = 0 THEN NULL
WHEN drugstartoffset <= drugstopoffset THEN drugstopoffset
WHEN drugstopoffset < drugstartoffset THEN drugstartoffset
END AS drugstopoffset,
drugorderoffset,
routeadmin,
m.frequency,
map.classification,
dosage
FROM eicu_full_phi.medication m
LEFT JOIN vanco.medication_frequency_map map
on m.frequency = map.frequency
WHERE
(drughiclseqno IN (10132,35848,37021) OR LOWER(drugname) LIKE '%cefepim%' OR LOWER(drugname) LIKE '%maxipim%'
OR drughiclseqno IN (4042, 10093, 8466, 37442) OR LOWER(drugname) LIKE '%vanco%'
OR drughiclseqno IN (8738, 32900, 33427) OR lower(drugname) like '%zosyn%' OR lower(drugname) like '%piperacillin%tazo%')
AND drugordercancelled = 'No'
AND prn = 'No'
AND COALESCE(map.classification, '') NOT IN
(
'TPN', 'dialysis', 'prophylactic', 'prn'
)
AND lower(m.frequency) NOT LIKE '%dialysis%'
AND lower(m.frequency) NOT LIKE '%prn%'
AND lower(m.frequency) NOT LIKE '%tpn%'
)
select ce.routeadmin,
abx.code,
-- below was the code used on eICU-CRD that covered all IV routes in the public data
CASE WHEN ce.routeadmin IN (
'IV',
'Intravenous',
'INTRAVENOU',
'INTRAVEN',
'IntraVENOUS',
'IV (intravenous) ',
'INTRAVENOUS',
'IV - brief infusion (intravenous) ',
'PERIPH IV',
'IV Push'
) THEN 1 ELSE 0 END AS in_original_query,
count(*) as n, count(distinct patientunitstayid) as n_pt
from ce
LEFT JOIN vanco.abx_route abx
ON ce.routeadmin = abx.routeadmin
group by 1, 2
order by 2, 3 desc;
routeadmin | code | in_original_query | n | n_pt |
---|---|---|---|---|
IV (intravenous) | IV | 1 | 66981 | 43208 |
PERIPH IV | IV | 1 | 27 | 15 |
INTRAVEN | IV | 1 | 73825 | 18837 |
INTRAVENOU | IV | 1 | 61584 | 16123 |
Intravenous | IV | 1 | 106668 | 31549 |
IntraVENOUS | IV | 1 | 6757 | 2887 |
INTRAVENOUS | IV | 1 | 5902 | 1329 |
IV | IV | 1 | 1446437 | 538850 |
IV - brief infusion (intravenous) | IV | 1 | 7522 | 5214 |
IV (intravenous) | IV | 0 | 1896 | 1305 |
INTRA-CATHET | IV | 0 | 1 | 1 |
Intercatheter | IV | 0 | 9 | 3 |
CATH | IV | 0 | 34 | 9 |
EXTENDEDIV | IV | 0 | 368 | 302 |
PEDIV | IV | 0 | 3 | 3 |
Catheter | IV | 0 | 3 | 2 |
CATHETER FLU | IV | 0 | 18 | 9 |
IV Sedation | IV | 0 | 1 | 1 |
Catheter lock | IV | 0 | 12 | 5 |
*IV | IV | 0 | 108 | 94 |
IV* | IV | 0 | 2 | 2 |
IV112 | IV | 0 | 3 | 3 |
IVNTRC | IV | 0 | 6 | 2 |
IV Continuous | IV | 0 | 11 | 11 |
IVD | IV | 0 | 1 | 1 |
IVDRIP | IV | 0 | 4 | 3 |
IVENTRIC | IV | 0 | 11 | 9 |
IVI | IV | 0 | 962 | 259 |
IV INFUSION | IV | 0 | 29270 | 5466 |
IVNT | IV | 0 | 3 | 1 |
IN VITRO | IV | 0 | 1 | 1 |
INTRAVEN. | IV | 0 | 12764 | 3028 |
Intracatheter | IV | 0 | 2 | 1 |
This seems to have increased cohort sizes by 30% across the board.
Old code missing IV administrations:
262498 patients.
Antibiotic use for 48 hours in the ICU:
23814 ( 9.1%) - vanco
4756 ( 1.8%) - cefepime
24190 ( 9.2%) - zosyn
Concurrent antibiotic use:
1958 ( 0.7%) - vanco & cefepime
9424 ( 3.6%) - vanco & zosyn
New code with all IV administrations:
262498 patients.
Antibiotic use for 48 hours in the ICU:
30694 (11.7%) - vanco
7119 ( 2.7%) - cefepime
31377 (12.0%) - zosyn
Concurrent antibiotic use:
3208 ( 1.2%) - vanco & cefepime
12718 ( 4.8%) - vanco & zosyn
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