史诗性败血症模型住院预测分析工具:一个验证研究
John Cull1, Robert Brevetta1, Jeff Gerac1
1All authors: Prisma Health, Greenville, SC.
Critical care explorations
|July 5, 2023
概括
在医院实施史诗性败血症模型 (ESM) 预警系统,使败血症相关死亡率降低了44%. 这种电子健康记录工具有望改善患者的治疗结果,并减少因败血症导致的死亡.
科学领域:
- 医疗保健信息学 医疗保健信息学
- 临界护理医学 临界护理医学
- 预测分析是一种预测分析.
背景情况:
- 早期的败血症治疗对于减少死亡率至关重要.
- 史诗性败血症模型 (ESM) 是一个电子医疗记录工具,旨在预测败血症.
- 对ESM有效性的外部验证是有限的.
研究的目的:
- 评估史诗性败血症模型 (ESM) 作为败血症查工具.
- 确定ESM实施是否与与败血症相关的死亡率降低有关.
主要方法:
- 在一个拥有746张床位的城市学术一级创伤中心,采用了前后研究设计.
- 成年急性护理住院患者在2018年1月至2019年7月期间进行了评估.
- 激活了ESM系统,以提醒供应商的败血症风险得分>=5.
主要成果:
- 作为败血症查工具,ESM表现出高灵敏度 (86.0%) 和负预测值 (98.11%).
- 在ESM实施后,警报患者的败血症相关死亡率从24.3%降至15.9%.
- 多变量分析表明,ESM实施与与败血症相关的死亡率降低44% (OR 0.56;95% CI 0.39-0.80) 之间存在显著的关联.
结论:
- 作为查工具使用的ESM评分与与败血症相关的死亡率大幅降低有关.
- 鉴于Epic的广泛使用,ESM提出了一个有希望的战略,以改善全国性败血症的结果.
- 需要进一步研究更严格的设计来证实这些发现.
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