针对急性胰腺炎 (BISAP) 严重程度的修改床边指数在国家住院患者样本数据库中的评分验证
Do Han Kim1, Frank J Lukens2, Donghyun Ko1
1Universidad Francisco Marroquin, School of Medicine, Guatemala City, Guatemala.
Advances in medical sciences
|June 17, 2023
概括
开发了一种新的修改BISAP (mBISAP) 评分来预测急性胰腺炎 (AP) 患者的死亡率. 这一分数有效地识别了高风险个体,表明高分数和死亡率增加之间存在强烈的相关性.
科学领域:
- 胃肠病学和肝病学
- 医疗保健服务研究 医疗服务研究
- 临床信息学 临床信息学
背景情况:
- 急性胰腺炎 (AP) 是致病率和死亡率的重要原因之一.
- 准确的风险分层对于管理AP患者至关重要.
- 对于特定的医疗保健数据库,现有的评分系统可能需要改进.
研究的目的:
- 开发和验证修改后的BISAP (mBISAP) 评分.
- 在医疗保健成本和利用项目数据库中增强AP的分类.
- 为了改善AP患者的死亡率预测.
主要方法:
- 使用了国家住院患者样本数据库 (2016-2019).
- 根据ICD-10CM特定临床指标的代码创建了一个mBISAP得分 (多发性溢出,脑病变,AKI,SIRS,年龄>60).
- 进行了多变量回归和灵敏度/特异性分析以预测死亡率.
主要成果:
- 确定了超过110万个AP排放.
- 在mBISAP得分为0-5 (P<0.01) 的情况下,组合死亡率显著增加.
- 每增加1分的mBISAP得分与死亡率显著增加相关 (aOR从6.67到535.38不等).
- 截止值≥3显示死亡率的特异性为97.7%,AUC为0.811.
结论:
- 该mBISAP得分有效预测AP患者的死亡率.
- 该得分显示,随着每次增加,死亡率的几率都在增加.
- 实现了高特异性 (97.7%),用于识别具有≥3.3的切断值的高危患者.
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