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加强地震相关伤害的分选和管理:SAFE-QUAKE评分系统用于预测透析需求
Sarper Yılmaz1, Remzi Cetinkaya2, Mehmet Ozel2
1University of Health Sciences, Dept. of Emergency Medicine, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey; Secretary of the Disaster Commission of the Turkish Emergency Medicine Association, Ankara, Turkey.
Prehospital and disaster medicine
|October 4, 2023
概括
一个新的评分系统,SAFE-QUAKE,有效地识别地震伤害患者不太可能需要透析. 该工具有助于管理急性损伤 (AKI) 和在灾区分配资源.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 灾难医学 灾难医学
- 创伤外科 手术 创伤外科
背景情况:
- 与地震相关的伤害经常导致急性损伤 (AKI),需要透析.
- 早期识别需要透析的患者对于资源管理和对大规模意外事件的干预至关重要.
- 需要预测工具来分层风险并指导创伤后AKI的临床决策.
研究的目的:
- 开发和验证功能地震评估以排除透析要求 (SAFE-QUAKE) 评分系统.
- 确定早期的临床和实验室预测器的透析需求的患者与地震相关的伤害.
- 为医疗保健提供者建立一个实用的工具,以排除在灾难环境中需要透析.
主要方法:
- 对205名地震相关伤害患者的回顾性分析,分为透析 (n=35) 和无透析 (n=170) 组.
- 人工神经网络 (ANN) 和单变量分析被用来确定透析的显著预测因素.
- 关键参数包括捕获的持续时间,pH,肌,乳酸脱酶 (LDH) 和AST与ALT的比率.
主要成果:
- 透析组的困时间显著更长 (48小时而不是8小时).
- 观察到群体之间的pH,乳酸盐,肌,LDH和AST/ALT比率有显著差异.
- 在139名患者中,SAFE-QUAKE评分,使用捕获<45小时,pH>7.31,肌素<2mg/dL,LDH<1600mg/dL,AST/ALT<2.4,实现了99.29%的负预测值.
结论:
- 该SAFE-QUAKE评分系统在排除地震伤害患者透析需求方面表现出高准确度 (99.29%的NPV).
- 这种实用工具可以帮助医疗保健提供者识别 AKI 风险较低的患者,需要在地震后进行透析.
- SAFE-QUAKE有助于有效地分配资源,及时干预受灾地区的风险人群.
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