喘预测工具在患有严重支气管炎的婴儿队列中的应用
Ronaldo C Fabiano Filho1, Ruth J Geller1, Ludmilla Candido Santos1
1Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
Pediatric allergy, immunology, and pulmonology
|August 28, 2023
概括
婴儿严重的支气管炎是儿童喘的重要危险因素. 这项研究评估了喘预测工具,发现儿科喘风险评分 (PARS) 显示为识别高风险婴儿最有前途.
科学领域:
- 儿科肺病学 儿科肺病学
- 喘流行病学 喘流行病学
- 临床预测模型临床预测模型
背景情况:
- 婴儿时期的严重支气管炎是患儿喘的主要危险因素.
- 早期和准确的喘预测对于及时干预至关重要.
- 现有的预测工具需要对高风险婴儿群体进行评估.
研究的目的:
- 评估喘预测指数 (API),修改后的API (mAPI) 和儿童喘风险评分 (PARS) 对6岁喘的预测准确度.
- 评估这些工具使用婴儿期数据在一个队列的婴儿住院治疗严重支气管炎.
- 确定最有效的工具来预测高风险婴儿的喘.
主要方法:
- 一项多中心队列研究,涉及2011年至2014年期间因严重支气管炎住院的1岁以下婴儿.
- 婴儿时期的数据被用来计算API (严格和宽松的标准),mAPI和PARS的分数.
- 在6岁时的喘诊断是通过父母报告的数据来确定的.
主要成果:
- 在6岁时,父母报告的喘患病率为37%.
- 积极预测率有所不同:API (严格) 21%,API (宽松) 51%,mAPI 11%和PARS 34%.
- 接收器运行特征曲线 (AUC) 下的面积从mAPI的0.57到PARS的0.66不等,表明预测能力中等.
结论:
- 儿科喘风险评分 (PARS) 在这个高风险队列中,在6岁时评估的喘指数中显示出最高的预测性表现.
- 目前的喘预测工具在准确识别所有高风险婴儿方面存在局限性.
- 需要开发更好的喘预测工具,以指导严重支气管炎的婴儿的预防策略.
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