与非移植受体相比,在重症移植受体中对血流感染的病理生理反应
Jiaxing Qiu1, Alex N Zimmet2, Taison D Bell3
1Department of Medicine, Division of Cardiovascular Diseases, Center for Advanced Medical Analytics, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
概括
血流感染 (BSI) 对重症移植和非移植患者构成类似的挑战. 在全身炎症反应综合征 (SIRS) 中调整发烧标准可以改善移植受体的BSI检测.
科学领域:
- 临界护理医学 临界护理医学
- 传染性疾病 传染性疾病
- 移植手术 移植手术
背景情况:
- 血流感染 (BSI) 在免疫抑制移植接受者中具有挑战性诊断.
- 系统性炎症反应综合征 (SIRS) 标准可能需要对这一群体进行修改.
研究的目的:
- 在重症移植和非移植受体中比较BSI反应.
- 修改SIRS标准,以改善移植患者的BSI查.
主要方法:
- 分析了来自UVA和Pitt的重症监护病房 (ICU) 的大型数据集.
- 开发了使用27个临床变量的多变量模型.
- 采用贝叶斯推理来调整SIRS对移植受体的标准.
主要成果:
- 在移植和非移植接受者之间,对BSI的单变异反应是可比的.
- 模型显示出良好的预测性能 (AUC从0.75到0.82不等).
- 37.5°C的上温度值改善了移植受体的SIRS重新分类.
结论:
- 重症移植和非移植接受者对BSI的反应类似.
- 修改后的SIRS标准,特别是37.5°C的发烧值,提高了移植受体的BSI查准确度.
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