一个风险评分来预测对上胃肠道出血的治疗需要
O Blatchford1, W R Murray, M Blatchford
1Department of Public Health, University of Glasgow, UK. o.blatchford@bigfoot.com
Lancet (London, England)
|November 10, 2000
概括
一个新的风险评分准确地识别了需要治疗急性上胃肠道出血的患者. 这种工具有助于临床医生有效地管理出血和分层患者的风险.
科学领域:
- 胃肠病学 胃肠病学
- 临床医学 临床医学
- 医疗信息学 医疗信息学
背景情况:
- 现有的急性上胃肠道出血 (UGIB) 风险分层系统将患者分类为高或低风险的死亡或再出血.
- 需要一个验证的风险评分来指导UGIB患者的治疗决策.
研究的目的:
- 开发和前性验证一种风险评分,用于识别需要医疗干预的UGIB患者.
- 创建一个简化的快速查工具,用于初始患者评估.
主要方法:
- 通过对1748名UGIB患者的数据进行逻辑回归,得出风险评分,预测需要输血,干预,再出血或死亡.
- 该得分和简化查工具在197名UGIB患者中被前性验证,使用接收器运行特征 (ROC) 曲线和chi2适合性测试.
主要成果:
- 风险评分包括入院血红蛋白,血尿素,脉,静脉血压,昏迷,,肝病和心力衰竭.
- 开发的得分显示出优异的区分 (ROC曲线面积为0.92) 和良好的校准 (p=0.84) 来预测治疗需要.
结论:
- 经验证的风险评分有效地识别出患有UGIB的患者需要治疗的风险低或高.
- 这一分数可以帮助临床管理UGIB,尽管建议进行外部验证.
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