预测儿童因灾难性烧伤的死亡率
Marcus Spies1, David N Herndon, Judah I Rosenblatt
1Shriners Hospitals for Children and Department of Surgery, The University of Texas Medical Branch, Galveston, TX 77550, USA.
Lancet (London, England)
|March 28, 2003
概括
准确预测大规模儿科烧伤的死亡率需要超越最初的人口统计数据的全面数据. 一个合并了临床变量的验证模型在预测严重烧伤儿童的结果时达到97%的准确性.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 烧伤伤害研究研究
- 在严重创伤中预后建模.
背景情况:
- 此前已经开发了一种关于大规模儿科烧伤 (>80%的总体表面积[TBSA]) 的生存预测模型.
- 最初的模型结合了来自医院过程的人口和临床变量.
- 这项研究旨在前性验证该模型的预测准确性.
研究的目的:
- 为了对先前开发的模型进行前性验证,用于预测患有大量烧伤的儿科患者的生存率.
- 评估结果预测的准确性,仅使用人口统计数据与全面的临床模型对比.
主要方法:
- 在33名患有>80%TBSA烧伤的儿科烧伤患者的前性验证.
- 收集的数据包括年龄,烧伤大小,吸入伤害,复苏状态以及各种实验室/临床参数.
- 这些变量被输入到之前开发的预测模型中.
主要成果:
- 该研究包括33名儿童 (20名男性,13名女性),平均年龄为7.6岁,88%的TBSA烧伤.
- 总体死亡率为39.4% (30人中的13人).
- 综合模型预测结果准确率为97%,而仅仅以人口统计学模型预测结果准确率仅为51%.
结论:
- 严重烧伤儿童的死亡率可以在烧伤中心设置中可靠地估计.
- 仅仅是人口和伤害特征就不足以可靠地预测结果.
- 严重烧伤的儿童应该在考虑治疗徒劳性的决定之前接受治疗.
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