开发和临床实证验证慢性重症预后预测模型的发展和临床经验验证
Li Zhao1,2, Wen-Kui Xu1, Ying Wang1
1School of Nursing, Fujian Medical University, Fuzhou, Fujian, China.
概括
一个新的慢性重症病的预后预测模型 (PPCCI) 准确地识别了患者的严重程度. 该工具有助于重症监护室 (ICU) 工作人员在资源分配和沟通方面,改善慢性重症患者的护理.
科学领域:
- 关键护理医学 关键护理医学
- 医学预测 医学预测
- 医疗信息学 医疗信息学
背景情况:
- 临界护理的进步提高了生存率,但并非总是长期的结果.
- 慢性重症 (CCI) 在患者的康复和预后方面存在持续的挑战.
- 需要客观的评估工具来有效管理CCI患者.
研究的目的:
- 开发和验证用于评估慢性重症疾病 (CCI) 严重程度的预测模型.
- 创建一个准确,精确和客观的工具来识别CCI患者预后.
- 加强临床决策在危急病患者的管理.
主要方法:
- 追溯病例控制和前性队列研究设计.
- 开发了使用344名患者的慢性重症病的预后预测模型 (PPCCI模型).
- 在88名患者的前性队列中验证PPCCI模型.
主要成果:
- 该PPCCI模型结合了9个预测因素:年龄,长时间机械通风,严重感染,GCS,MAP,HR,RR,OI和活跃出血.
- 与APACHE II,MEWS和SOFA相比,PPCCI模型在预测开发和验证队列中的死亡率方面表现优越.
- 曲线下的高面积 (AUC) 值 (0.934在开发中,0.965在验证中) 表示强大的预测准确性.
结论:
- PPCCI模型为ICU医务人员提供了一个标准化的工具,用于评估CCI患者的病情.
- 该模型有助于合理分配病房监测资源.
- 它改善了与家庭成员关于患者预后的沟通.
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