- Open Access
Impact of Rothman index on delay of ICU transfer for hematology and oncology patients deteriorating in wards
© The Author(s). 2018
- Received: 9 November 2018
- Accepted: 21 November 2018
- Published: 4 December 2018
We performed a before/after study comparing 86 patients transferred from wards to the ICU before RI implementation (the RI was computed from electronic medical records but not available to staff) with 86 consecutive patients transferred after RI implementation and staff training. We collected the lowest RI within 24 h prior to ICU transfer (low RI), the delay between low RI and ICU transfer, and whether and when patients reached validated alarms of 40 (high risk) and 20 (very high risk) for the RI prior to transfer. The SOFA score on ICU admission, vital organ support in the ICU and mortality were collected.
Main characteristics and comparison of hematology and oncology patients transferred to the ICU from the ward before (pre-RI) and after (post-RI) implementation of the Rothman index (RI)
Pre-RI (n = 86)
Post-RI (n = 86)
Gender, male/female, (n)
Charlson comorbidity index
Hematological malignancy, n(%)
Cardiac arrest day 1, n(%)
Sepsis day 1, n(%)
Mechanical ventilation day 1, n(%)
Duration of mechanical ventilation (days)
Vasopressors day 1, n(%)
SOFA score day 1
ICU mortality, n(%)
Hospital mortality, n(%)
Delay lowest RI—ICU (h)
Alert RI < 40, n(%)
Alert RI < 20, n(%)
Delay RI < 40—ICU (h)
Delay RI < 20—ICU (h)
In this small population of oncology patients deteriorating in wards, implementation of the RI did not result in patients being transferred to the ICU earlier or with fewer organ failures. This raises concerns about staff training and proper use of the RI in routine. More studies are warranted to translate this sophisticated and expensive tool into survival benefits for the patients.
Availability of data and materials
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
AVdL designed the study, analyzed data and wrote the manuscript. NF and DG collected and analyzed data. All authors read and approved the final manuscript.
Ethics approval and consent to participate
This study was approved by the Pennsylvania State University College of Medicine IRB (number 7601) and informed consent was waived due to the retrospective data collection.
Consent for publication
The authors declare that they have no competing interests.
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