预测结肠直肠手术再入院风险:一个特定于手术的预测模型
Thomas Clark Howell1,2, Stephanie Lumpkin1,2, Nicole Chaumont2,3
1Department of Surgery, Duke University, Durham, NC.
IISE transactions on healthcare systems engineering
|August 17, 2023
概括
使用结直肠外科手术患者的综合数据开发新的预测模型,与现有方法相比,显著改善了30天再入院风险预测.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 医疗保健服务研究 医疗服务研究
- 预测建模预测建模
背景情况:
- 目前的再接收风险模型往往缺乏针对手术患者群体的特异性.
- 仅仅管理数据可能无法捕捉影响手术患者再入院的所有因素.
研究的目的:
- 专门为结直肠外科手术患者开发和验证30天再入院风险的预测模型.
- 根据现有的指数,评估一个全面的,手术特定模型的性能.
主要方法:
- 对1549名结直肠手术患者 (2017-2019) 的回顾性队列研究.
- 使用行政,临床,实验室和社会经济地位 (SES) 数据开发一个多变量后勤回归模型.
- 对比新模型的预测准确性 (C-统计) 与两个已建立的再接收风险指数.
主要成果:
- 30天的再接收率为19.62%.
- 开发的手术特异模型实现了0.70的C-统计,超过了两个国际指数 (C=0.58和C=0.60).
- 包括SES和临床数据在内的全面数据集改善了模型性能.
结论:
- 结合多种数据源的手术特异性预测模型提高了结直肠手术中的30天再录取风险预测.
- 包括社会经济和临床因素在内的全面数据对于准确评估手术患者的再入院风险至关重要.
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