Curation and description of a blood glucose management and nutritional support cohort using the eICU collaborative research database

Abstract

AbstractFreely available electronic medical record (EMR) data collections have transformed data science and observational research in critical care medicine. Descriptive characterisation of these data collections can aid in highlighting variation in clinical practice and patient outcomes across Intensive Care Units (ICUs). Glycaemic control and nutritional management are important aspects of patient management in the ICU. Blood glucose on admission has a well-known U-shaped relationship with mortality and morbidity, with both hypo- and hyper-glycemia being associated with poor patient outcomes. The importance of nutritional support has been highlighted in critical care guidelines. However, both areas have open research questions and highly variable clinical practices that observational data may help highlight and inform. To aid in this research, we curated a database of patients using the eICU collaborative research data (eICU-CRD), which we describe in the current paper, focusing on patient blood glucose, insulin therapy and enteral nutrition. The eICU-CRD is derived from a telehealth EMR covering 208 United States hospitals from 2014-2015. In addition to descriptive statistics and graphical analysis, we highlight any limitations in data quality. Our results are in line with previous research suggesting the eICU-CRD cohort is of lower illness severity than the average ICU patient cohort and so receive less invasive interventions. Examinations of data missingness revealed issues with medication orders and non-reporting of nutrition by several hospitals. Overall, with care around missingness we believe the eICU-CRD to be a valuable resource in evidence generation for critical care research.