对比NIRUDAK模型和世卫组织算法来评估急性腹的老年儿童和成人脱水情况:一项前性观察性研究
Adam C Levine1, Monique Gainey2, Kexin Qu3
1Department of Emergency Medicine, Warren Alpert Medical School, Brown University, Providence, RI, USA.
The Lancet. Global health
|September 30, 2023
概括
新的工具可以准确地评估急性腹儿童和成人脱水情况. 临床决策支持工具 (CDST) 和简化得分改进了世卫组织的指导方针,可能减少疾病和死亡.
科学领域:
- 临床医学 临床医学
- 公共卫生 公共卫生
- 儿科 儿科 儿科
背景情况:
- 对于急性腹患者来说,准确评估水分状态至关重要.
- 目前还没有有效的工具来评估老年儿童和成人脱水的严重程度.
- 现有的世界卫生组织 (WHO) 准则可能缺乏足够的准确性和可靠性.
研究的目的:
- 验证临床决策支持工具 (CDST) 和简化得分,以评估急性腹的老年儿童和成人脱水严重程度.
- 将这些新型工具的准确性和可靠性与当前的世卫组织指南进行比较.
主要方法:
- 在孟加拉国达卡 icddr,b医院对1580名年龄在5岁或以上的急性腹患者进行前性队列研究.
- 患者使用新工具和世卫组织指南进行了评估,并对脱水严重程度进行了分类.
- 精度是使用顺序c指数 (ORC) 测量,可靠性是使用类内相关系数 (ICC) 测量,重水化过程中的百分比重量变化作为标准标准.
主要成果:
- 与世卫组织指南 (ORC 0.64) 相比,CDST (ORC 0.74) 和简化得分 (ORC 0.75) 在诊断脱水方面表现出更高的准确性.
- 与世卫组织指南 (ICC 0.56) 相比,这两种新型工具都显示出高可靠性 (CDST ICC 0.98,简化得分 ICC 0.94).
- 简化得分和CDST显示了两个独立的护士之间的优秀的互评分可靠性.
结论:
- 经过验证的CDST和简化得分为评估急性腹的老年儿童和成人脱水提供了更准确和可靠的方法.
- 这些工具的实施可能会导致治疗不足和治疗过度减少,从而降低与急性腹相关的发病率和死亡率.
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