儿科计划外抽风险评分:风险评估的预测模型
Valéria C Neves1, Camila G R Locatelli2, Olivia Ramalho3
1Pediatric Intensive Care Unit, Complexo Hospital de Clínicas, Universidade Federal do Paraná (UFPR), Curitiba, (PR), Brazil; Department of Pediatrics, Universidade Federal do Paraná (UFPR), Curitiba, (PR), Brazil.
Heart & lung : the journal of critical care
|June 12, 2023
概括
在儿科重症监护中,可以使用儿科非计划性输出管风险评分来预测非计划性输出管. 该工具确定了预防被直管儿童不良事件的关键风险因素.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 患者安全研究的研究.
- 机械通风管理系统的管理.
背景情况:
- 无计划的输出管是机械通风患者常见的,可预防的不良事件.
- 有效的风险分层对于改善儿科重症监护室 (PICU) 患者的治疗结果至关重要.
研究的目的:
- 开发和验证一个预测模型,即儿科无计划输出管风险评分,用于识别在PICU中患有无计划输出管风险高的儿童.
- 确定与儿科患者无计划输出管道相关的重大风险因素.
主要方法:
- 一个单一的中心,在PICU进行的观察性研究.
- 纳入标准:需要侵入性机械通风的儿科患者 (28天至14岁).
- 在2年时间内开发和应用儿科非计划性输出管风险评分,共计2,153次观察.
主要成果:
- 儿科无计划输出管风险评分 (Pediatric Unplanned Extubation Risk Score) 确定了几种无计划输出管的重要风险因素.
- 关键因素包括:内管固定不充分 (OR 2.00),镇静不充分 (OR 3.00),年龄≤12个月 (OR 1.27),呼吸道过分分泌 (OR 11.00),家庭/护士支持不充分 (OR 5.00),以及断奶期 (OR 3.00).
- 在2,153次观察中,有73次发生了无计划的输出.
结论:
- 开发的评分系统在预测意外输出管风险方面表现出良好的灵敏度.
- 该模型有效地整合了六个关键方面,这些方面可以作为孤立或联合的风险因素,有助于主动的患者管理.
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