早期预警系统可以准确预测急性胃肠道出血的死亡风险,这些人被送往重症监护室
Meng Jiang1, Chang-Li Li2, Xing-Chen Lin3
1Emergency and Trauma Center, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, 310003, Zhejiang, People's Republic of China. jmhust@zju.edu.cn.
Internal and emergency medicine
|September 23, 2023
概括
一个新的风险评分准确地预测了急性胃肠道出血患者进入重症监护室 (ICU) 的死亡率. 该工具有助于早期识别高风险患者,改善预后和患者护理.
科学领域:
- 关键护理医学 关键护理医学
- 胃肠病学 胃肠病学
- 医疗信息学 医疗信息学
背景情况:
- 急性胃肠道 (GI) 出血是一种危及生命的紧急情况,需要立即分层风险.
- 由于急性胃肠道出血而入住重症监护室 (ICU) 的患者面临高死亡率.
- 对于这种患者群体,现有的风险分层工具是有限的.
研究的目的:
- 开发和验证一种新的风险评分,用于预测急性胃肠道出血患者在ICU入院时的死亡率.
- 为了提高患有胃肠道出血的重症患者的预后的准确性.
主要方法:
- 使用eICU协作研究数据库 (eICU-CRD) 的数据开发了一个名图.
- 内部验证是使用eICU-CRD队列进行的,外部验证是在密集护理III (MIMIC-III) 和武汉通吉医院密集护理III (MIMIC-III) 的医疗信息市场中进行的.
- 模型的性能使用歧视 (C指数),校准 (校准曲线) 和实用性 (决策曲线) 来评估.
主要成果:
- 纳米图,包含十个变量,在所有队列中显示出良好的校准和歧视 (C指数0.8320.926).
- 通过名图识别的高风险患者与低风险患者相比,死亡率明显高 (例如,44.8%与3.5%).
- 在死亡率预测方面,开发的名录表在死亡率预测方面表现优于既定得分 (格拉斯哥-布拉奇福德,AIMS65,奥克兰,森古普塔).
结论:
- 开发的诺米图是可靠的预后工具,用于识别高风险的急性胃肠道出血患者在ICU.
- 这种工具可以帮助临床医生及时和适当地进行医疗干预和资源分配.
- 进一步实施这个名谱可能会提高重症监护机构的患者的治疗结果.
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