Vasopressor and antibiotics in MIMIC3

Question

I think I noticed an issue, but not sure whether it is correct.

It looks like the administration record of antibiotics/vasopressor are found in the PRESCRIPTION table. However, I discovered that the table is only about CPOE entry, and not about whether the certain drug was really administered. For instance, I cannot find the trend of doses of norepinephrine infusion in the table.

INPUTEVENTS_MV has the data of real-time administration. (for instance, a row in the table might tell you that a patent was given 5ug/hr of vasopressor between 7-9 pm). However, I cannot find anything about med administration in INPUTEVENTS_CV (only fluid administration).

My understanding is that INPUTEVENTS_MV is for patients who visited the hospital after 2008 and INPUTEVENTS_CV is for 2001-2008. My question is whether the only option for me is just to use the data after > 2008 if my research requires the trend of vasopressor administration?

Answer 1

It looks like the administration record of antibiotics/vasopressor are found in the PRESCRIPTION table.

The prescriptions table is a record of medications that were ordered. It does not indicate whether or not the medication was administered. This data is extracted from a Computerized Physician Order Entry ('CPOE') system.

My question is whether the only option for me is just use the data after 2008 if my research requires the trend of vasopressor administration?

Medications admitted intravenously are tracked in the inputevents_cv (~pre-2008) and inputevents_mv (~post-2008) tables. If you are interested in exploring vasopressor administration in the inputevents_cv table, then you should first identify relevant itemids in the d_items table.

One useful reference is the code used for calculating the Sequential Organ Failure Assessment (SOFA), which you can find in the MIMIC Code Repository.

Relevant snippet of SQL here:

vaso_cv as
(
  select ie.icustay_id
    -- case statement determining whether the ITEMID is an instance of vasopressor usage
    , max(case
            when itemid = 30047 then rate / coalesce(wt.weight,ec.weight) -- measured in mcgmin
            when itemid = 30120 then rate -- measured in mcgkgmin ** there are clear errors, perhaps actually mcgmin
            else null
          end) as rate_norepinephrine

    , max(case
            when itemid =  30044 then rate / coalesce(wt.weight,ec.weight) -- measured in mcgmin
            when itemid in (30119,30309) then rate -- measured in mcgkgmin
            else null
          end) as rate_epinephrine

    , max(case when itemid in (30043,30307) then rate end) as rate_dopamine
    , max(case when itemid in (30042,30306) then rate end) as rate_dobutamine

  from icustays ie
  inner join inputevents_cv cv
    on ie.icustay_id = cv.icustay_id and cv.charttime between ie.intime and ie.intime + interval '1' day
  left join wt
    on ie.icustay_id = wt.icustay_id
  left join echo2 ec
    on ie.icustay_id = ec.icustay_id
  where itemid in (30047,30120,30044,30119,30309,30043,30307,30042,30306)
  and rate is not null
  group by ie.icustay_id
)

More detail is provided in the Scientific Data paper and in the MIMIC documentation.