PROSPECT

Every year in the United Kingdom 1 in 10 (14,000) people discharged from an Intensive Care Unit (ICU) die unexpectedly, or urgently return to an ICU before hospital discharge. Of those who leave hospital, a quarter are unexpectedly readmitted within 3 months. It is not known whether additional electronic health information about patients discharged from ICU may support critical care follow-up staff to prioritise who to monitor more closely.

The PROgnosiS Prediction after Enhanced or CriTical care (PROSPECT) study aims to develop a digital system including wearable monitoring (already established in other in-hospital populations) to find patients who are most likely to deteriorate in the near future, both in their post-ICU in-hospital stay and in the early period following hospital discharge.

To do this, we will:

• Use information from earlier research studies and experts to pinpoint which patient information (for example, certain blood tests) would be most useful to spot people at high risk of deterioration after ICU discharge,
• extract relevant information from historical patient records, looking at who has these risk factors and which patients deteriorated after ICU discharge,
• ask patients to wear a monitoring system for up to 14 days after discharge from ICU, and for 14 days after discharge from hospital,
• build tools to combine hospital information with information from the wearable devices to estimate the risk of deterioration in patients after an ICU admission,
• implement these tools into a “real-time” digital platform that could be used to find which people are high risk and may benefit from clinical review or closer monitoring, and
• test the platform usability with clinical stakeholders.

This study will include an initial pilot phase where we will work with clinical staff and patients to understand how best to use the information from this monitoring system in clinical practice.