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http://hdl.handle.net/1942/30457
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DC Field | Value | Language |
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dc.contributor.author | Carmen, Raïsa | - |
dc.contributor.author | Yom-Tov, Galit B | - |
dc.contributor.author | VAN NIEUWENHUYSE, Inneke | - |
dc.contributor.author | Foubert, Bram | - |
dc.contributor.author | Ofran, Yishai | - |
dc.date.accessioned | 2020-02-07T15:10:28Z | - |
dc.date.available | 2020-02-07T15:10:28Z | - |
dc.date.issued | 2019 | - |
dc.date.submitted | 2020-02-05T16:58:08Z | - |
dc.identifier.citation | PLOS ONE, 14 (3) (Art N° e0211694) | - |
dc.identifier.uri | http://hdl.handle.net/1942/30457 | - |
dc.description.abstract | Patients with hematological malignancies are susceptible to life-threatening infections after chemotherapy. The current study aimed to evaluate whether management of such patients in dedicated inpatient and emergency wards could provide superior infection prevention and outcome. | - |
dc.description.abstract | MotivationPatients with hematological malignancies are susceptible to life-threatening infections after chemotherapy. The current study aimed to evaluate whether management of such patients in dedicated inpatient and emergency wards could provide superior infection prevention and outcome.MethodsWe have developed an approach allowing to retrieve infection-related information from unstructured electronic medical records of a tertiary center. Data on 2,330 adults receiving 13,529 chemotherapy treatments for hematological malignancies were identified and assessed. Infection and mortality hazard rates were calculated with multivariate models. Patients were randomly divided into 80: 20 training and validation cohorts. To develop patient-tailored risk-prediction models, several machine-learning methods were compared using area under the curve (AUC).ResultsOf the tested algorithms, the probit model was found to most accurately predict the evaluated hazards and was implemented in an online calculator. The infection-prediction model identified risk factors for infection based on patient characteristics, treatment and history. Observation of patients with a high predicted infection risk in general wards appeared to increase their infection hazard (p = 0.009) compared to similar patients observed in hematology units. The mortality-risk model demonstrated that for infection events starting at home, admission through hematology services was associated with a lower mortality hazard compared to admission through the general emergency department (p = 0.007). Both models show that dedicated hematological facilities and emergency services improve patient outcome post-chemotherapy. The calculated numbers needed to treat were 30.27 and 31.08 for the dedicated emergency and observation facilities, respectively. Infection hazard risks were found to be non-monotonic in time.ConclusionsThe accuracy of the proposed mortality and infection risk-prediction models was high, with the AUC of 0.74 and 0.83, respectively. Our results demonstrate that temporal assessment of patient risks is feasible. This may enable physicians to move from one-point decision-making to a continuous dynamic observation, allowing a more flexible and patient-tailored admission policy. | - |
dc.description.sponsorship | This research was supported by the ISRAEL SCIENCE FOUNDATION (grant No. 1955/15). | - |
dc.language.iso | en | - |
dc.publisher | PUBLIC LIBRARY SCIENCE | - |
dc.rights | © 2019 Carmen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. | - |
dc.subject.other | Anti-Bacterial Agents | - |
dc.subject.other | Antineoplastic Agents | - |
dc.subject.other | Computer Simulation | - |
dc.subject.other | Female | - |
dc.subject.other | Hematologic Neoplasms | - |
dc.subject.other | Humans | - |
dc.subject.other | Infections | - |
dc.subject.other | Machine Learning | - |
dc.subject.other | Male | - |
dc.subject.other | Middle Aged | - |
dc.subject.other | Precision Medicine | - |
dc.subject.other | Retrospective Studies | - |
dc.subject.other | Risk | - |
dc.subject.other | Tertiary Care Centers | - |
dc.subject.other | Hospital Departments | - |
dc.subject.other | Infection Control | - |
dc.subject.other | Specialization | - |
dc.title | The role of specialized hospital units in infection and mortality risk reduction among patients with hematological cancers | - |
dc.type | Journal Contribution | - |
dc.identifier.issue | 3 | - |
dc.identifier.volume | 14 | - |
local.bibliographicCitation.jcat | A1 | - |
local.publisher.place | 1160 BATTERY STREET, STE 100, SAN FRANCISCO, CA 94111 USA | - |
local.type.refereed | Refereed | - |
local.type.specified | Article | - |
local.bibliographicCitation.artnr | e0211694 | - |
dc.source.type | Article | - |
dc.identifier.doi | 10.1371/journal.pone.0211694 | - |
dc.identifier.pmid | 30893320 | - |
dc.identifier.isi | WOS:000461765900008 | - |
dc.identifier.eissn | 1932-6203 | - |
local.provider.type | PubMed | - |
local.uhasselt.uhpub | yes | - |
item.contributor | Carmen, Raïsa | - |
item.contributor | Yom-Tov, Galit B | - |
item.contributor | VAN NIEUWENHUYSE, Inneke | - |
item.contributor | Foubert, Bram | - |
item.contributor | Ofran, Yishai | - |
item.validation | ecoom 2020 | - |
item.fulltext | With Fulltext | - |
item.accessRights | Open Access | - |
item.fullcitation | Carmen, Raïsa; Yom-Tov, Galit B; VAN NIEUWENHUYSE, Inneke; Foubert, Bram & Ofran, Yishai (2019) The role of specialized hospital units in infection and mortality risk reduction among patients with hematological cancers. In: PLOS ONE, 14 (3) (Art N° e0211694). | - |
Appears in Collections: | Research publications |
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File | Description | Size | Format | |
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PLOS-2019-publication.pdf | Published version | 1.37 MB | Adobe PDF | View/Open |
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