针对老年人重症监护室 (ICU) 的生存率和死亡率,开发一个人口级预测模型:基于人口的队列研究
Sikandar H Khan1,2,3, Anthony J Perkins4, Mikita Fuchita5
1Division of Pulmonary, Critical Care Sleep and Occupational Medicine Indianapolis Indiana USA.
Health science reports
|October 23, 2023
概括
一个新的风险模型有助于识别患重症监护病房 (ICU) 住院和死亡风险较高的老年人. 该工具帮助研究人员和卫生系统预测社区住户老年人的ICU结果.
科学领域:
- 老年学是一门学科.
- 关键护理医学 关键护理医学
- 医疗信息学 医疗信息学
背景情况:
- 人口老龄化正在增加重症监护的利用率.
- 需要人口层面的风险模型来预测重症监护室 (ICU) 的生存率和死亡率.
- 现有的模式可能无法充分满足社区老年人的需求.
研究的目的:
- 开发一个预测ICU存活率和死亡率的风险模型.
- 为了确定与老年人ICU结局相关的关键电子健康记录 (EHR) 变量.
- 为研究人员和卫生系统提供一个工具,以便在这个人口中分层风险.
主要方法:
- 一项基于人口的队列研究,对48127名年龄在50岁及以上的患者进行了研究.
- 利用了2017年至2017年期间初级保健访问的电子健康记录 (EHR) 数据.
- 使用多项逻辑回归和交叉验证来开发和验证风险模型.
主要成果:
- 该模型确定了三个结果的预测因素:活着而没有接受ICU治疗,ICU幸存者和死亡.
- 关键的危险因素包括晚年,慢性阻塞性肺部疾病,慢性心力衰竭和特定的实验室异常.
- 风险评分显示死亡率 (AUC=0.858) 和ICU存活率 (AUC=0.765) 的区别很好.
结论:
- 开发的风险评分为识别风险患者队列提供了一种可行和可扩展的方法.
- 该工具可以帮助研究人员和卫生系统管理ICU入院和生存情况.
- 建议在不同患者群体进行进一步的前性验证.
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