Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

OBJECTIVES: To derive outcome-based critical result thresholds in the adult patient population. METHODS: We extracted deidentified laboratory results and outcomes (death or discharged) of patients 18 years and older from the Medical Information Mart for Intensive Care database. The lower and upper critical result thresholds were obtained from the nearest minimum and maximum laboratory values, which corresponded to predicted probability of death at 90%. RESULTS: The critical value thresholds were sodium (<123, >153 mmol/L), potassium (<2.2, >6.6 mmol/L), bicarbonate (<15, >49 mmol/L), chloride (<82, >121 mmol/L), urea (>20 mmol/L), creatinine (>1,052 μmol/L), glucose (<1.5, >23.8 mmol/L), total calcium (<1.62, >2.95 mmol/L), magnesium (<0.37, >1.48 mmol/L), phosphate (<0.19, >2.52 mmol/L), pH (<7.22, >7.57), lactate (>5.0 mmol/L), hemoglobin (<4.6 g/dL), WBCs (>32 × 103/μL), prothrombin time (>90 seconds), and international normalized ratio (>10). CONCLUSIONS: The indirect approach described in this study is a pragmatic way to obtain threshold values that are clinically and operationally meaningful.

Original publication

DOI

10.1093/ajcp/aqz026

Type

Journal article

Journal

Am j clin pathol

Publication Date

05/07/2019

Volume

152

Pages

177 - 184

Keywords

Critical reporting, Critical results, Critical value, Panic value, Postanalytical, Adolescent, Adult, Aged, Aged, 80 and over, Clinical Laboratory Techniques, Critical Care, Databases, Factual, Female, Humans, Male, Middle Aged, Young Adult