Fig. 1

Study design. a Schematic representation of the dynamic model updating procedure. For example, to predict deterioration for patients admitted to hospital A in October 2020, the model is fitted using patient data collected up to that date in the remaining hospitals, and a calibrator is fitted using patient data collected up to that date in hospital A. These two combined result in calibrated predictions. This process is repeated each month, for each hospital, from August 2020 until May 2021. b Flowchart of patient inclusion. ICU = intensive care unit, ED = emergency department, EoLC = end-of-life care, LOS = length-of-stay