在3岁以下的儿童中,形创伤后的儿科椎损伤:PEDSPINE II研究
Casey M Luckhurst1, Holly M Wiberg2, Rebeccah L Brown3
1Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston.
JAMA surgery
|September 13, 2023
概括
这项研究开发了一种新的预测模型,以减少儿科突击创伤患者中不必要的椎脊柱成像. 该模型在识别伤害方面表现出卓越的准确性,可能降低成本和辐射暴露.
科学领域:
- 儿科创伤护理 儿童创伤护理
- 诊断成像 诊断成像 诊断成像
- 临床预测建模临床预测建模
背景情况:
- 在诊断子宫脊椎损伤 (CSI) 中存在显著的变化,在儿科突击创伤患者中.
- 目前的成像实践导致成本增加,辐射暴露和潜在的过度诊断.
研究的目的:
- 开发和验证一个预测模型,以指导儿科突击创伤中的椎脊柱成像.
- 确定成像利用的趋势,并评估PEDSPINE模型的性能.
主要方法:
- 在15个中心对9389名儿科患者 (<3岁) 进行了回顾性队列研究,这些患者患有重创伤.
- 使用临床标准开发一个多类分类算法.
- 验证PEDSPINE II模型并与原来的PEDSPINE评分进行比较.
主要成果:
- 该PEDSPINE II研究包括9389名患者,CSI率为1.36%.
- 80%的患者接受了椎脊柱成像,与之前的PEDSPINE研究相比有所增加.
- 与PEDSPINE评分 (AUC 0.845) 相比,PEDSPINE II模型在预测任何损伤方面实现了0.885的更高AUC.
结论:
- 评估儿科突击创伤患者的临床变异性导致成像使用的增加.
- 开发的预测工具可以帮助临床决策,减少成像利用,降低相关成本和辐射暴露.
- PEDSPINE II 模型在儿童重创伤中识别 CSI 的准确性得到了改进.
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