预后模型用于需要机械通风的动脉瘤下arachnoid出血患者
Xichen Wan1, Xiao Wu1, Junwei Kang2
1Department of Neurosurgery, First Affiliated Hospital of Nanchang University, Nanchang, 330006, People's Republic of China.
Annals of clinical and translational neurology
|July 10, 2023
概括
现在可以预测动脉瘤下关节出血 (aSAH) 患者在机械通风中的长期结果. 一个新的LASSO处罚的考克斯回归模型确定了改善患者管理的关键预后因素.
科学领域:
- 神经外科 神经外科
- 关键护理医学 关键护理医学
- 生物统计学 生物统计学
背景情况:
- 动脉瘤下关节出血 (aSAH) 是导致死亡和残疾的主要原因.
- 预测需要机械通风的aSAH患者的长期预后存在重大挑战.
研究的目的:
- 开发一个预测模型,用于机械通风的aSAH患者的长期结果.
- 使用易于获取的临床变量进行预后估计.
主要方法:
- 采用最小绝对收缩和选择操作员 (LASSO) 处罚的考克斯回归.
- 使用培训和验证套件识别和验证了预后因素.
- 使用ROC曲线,校准曲线和决策曲线分析 (DCA) 评估模型性能.
主要成果:
- 确定的主要独立预后因素包括简化急性生理学得分2,早期脑损伤,再出血和ICU停留时间.
- 该模型表现出高预测准确度,AUC值分别为0.82,0.81和0.80,为1年,2年和4年的生存期.
- 为了临床应用,开发了一个基于网络的nomogram.
结论:
- 开发的模型是预测机械通风aSAH患者的长期结果的宝贵工具.
- 这个工具可以帮助个性化干预和改进患者护理策略.
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