Ventilatory strategies and outcomes for patients acutely admitted to hospital

Dataset 14.0 Version 1.0 15.2.2021

Background. Acute respiratory failure is commonly encountered in the emergency department (ED). Early treatment can have positive effects on long-term outcome. Non-invasive ventilation is commonly used for patients with respiratory failure during acute exacerbations of chronic obstructive lung disease and congestive heart failure. For other patients, including neuromuscular dysfunction, mechanical ventilation may be needed. For refractory hypoxemia, new rescue therapies have emerged to help improve the oxygenation, and in some cases mortality. This dataset summarises the demography, admitting complaint, serial physiology, treatments and ventilatory strategies in patients admitted with hypoxaemia. Management options and rescue therapies including extracorporeal membrane oxygenation are included.

PIONEER geography The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix. There is a higher than average percentage of minority ethnic groups. WM has a large number of elderly residents but is the youngest population in the UK. Each day >100, 000 people are treated in hospital, see their GP or are cared for by the NHS.

EHR. University Hospitals Birmingham NHS Foundation Trust (UHB) is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & 100 ITU beds. ITU capacity increased to 250 beds during the COVID pandemic. UHB runs a fully electronic healthcare record (EHR) (PICS Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”. The electronic record captures ventilatory parameters.

Scope: All hospitalised patients with hypoxaemia requiring ventilatory support from 2000 onwards. The dataset includes highly granular patient demographics & co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to care process (timings, staff grades, specialty review, wards), severity, ventilatory requirements, acuity, all physiology readings (pulse, blood pressure, respiratory rate, oxygen saturations), all blood results, microbiology, all prescribed & administered treatments (fluids, antibiotics, inotropes, vasopressors, organ support), all outcomes.

Available supplementary data: Synthetic data. Post discharge care contacts.

Available supplementary support: Analytics, Model build, validation & refinement A.I. Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.