预测老年患者的短期死亡率,这些老年患者在持续不到24小时的急性住院后被送出院
Amalia Lærke Kjær Heltø1,2, Emilie Vangsgaard Rosager1,2, Martin Aasbrenn3
1Department of Emergency Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
Clinical epidemiology
|June 16, 2023
概括
一个新的模型预测了老年患者在短时间住院后30天的死亡风险. 关键预测因素包括年龄,痴呆症,药物和实验室结果,帮助医生做出患者出院决定.
科学领域:
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
- 预测分析是一种预测分析.
背景情况:
- 老年人住院次的增加需要更好的风险评估.
- 在出院后识别高风险患者对于及时干预至关重要.
研究的目的:
- 在短时间急性住院后,为老年患者的30天死亡率开发一个预测模型.
- 评估模型性能如何随着数据输入的增加而变化.
主要方法:
- 在丹麦 (2016-2018) 基于急性住院病例 (≤24小时) 的登记册研究.
- 包括65岁以上的患者,活着出院.
- 开发随机森林模型,逐渐增加预测变量.
主要成果:
- 包括107,132名患者 (平均年龄75岁);3.3%的人在30天内死亡.
- 随着实验室结果,先前入院,并发症和处方数据 (AUROC 0.860) 的改善,模型性能显著提高.
- 关键预测因素:年龄,痴呆症,处方药的数量,C反应蛋白和eGFR.
结论:
- 开发的模型准确地预测了退院后老年患者的短期死亡风险.
- 适用于各种临床环境,为医生提供有价值的工具.
- 强调临床和行政数据对于风险分层的重要性.
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