Does adding risk-trends to survival models improve in-hospital mortality predictions? A cohort study.

These three trend indicators were still highly significant ( p < .0001) when added jointly to the existing model using the following transformations: X 3 + X 3 *log(X) for the absolute change in the risk score from the previous day; X 0.5 + X 0.5 *log(X) for the absolute change in the risk score from the start of the trend; and X -2 + X -2 *log(X) for the number of consecutive days with a trend in the risk score (we first shifted all original values up by the minimum observed value to ensure the values were greater than zero).

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The adjusted hazard ratio decreased as the number of days with a decreasing trend in the risk score increased (Figure 2A , dotted line) and as the absolute change in the risk score from the previous day decreased (Figure 2B , dotted line).

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The adjusted hazard ratio increased as the number of days with an increasing trend in the risk score increased (Figure 2A , solid line), the absolute change in the risk score from the previous day increased (Figure 2B , solid line), and the absolute change in the risk score from the start of the trend increased (Figure 2C, s olid line).

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