成人重症监护室中亚症候群 Delirium 的动态 Nomogram:一个前性队列研究
Junning Cheng1, Yuewen Lao1, Xiangping Chen1
1Nursing Department, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, People's Republic of China.
Neuropsychiatric disease and treatment
|November 29, 2023
概括
这项研究开发了一种动态名图,用于预测重症监护病房 (ICU) 患者的亚症候群 Delirium (SSD). 诺米图表表现出良好的预测性能,有助于在ICU中早期检测和管理SSD.
科学领域:
- 临界护理医学 临界护理医学
- 神经学 神经学
- 医疗信息学 医疗信息学
背景情况:
- 副综合征性妄想 (SSD) 是重症监护室 (ICU) 患者常见的并发症.
- 早期预测和SSD的管理对于改善患者的治疗结果至关重要.
- 现有的预测工具可能缺乏实时临床应用的动态功能.
研究的目的:
- 为预测重症监护室 (ICU) 患者的副综合征性妄想 (SSD) 开发动态名录.
- 为了内部验证开发的名录在预测SSD中的有效性.
- 为早期预测和管理SSD提供精确有效的工具.
主要方法:
- 包括1000名ICU患者的队列,数据随机分为培训 (70%) 和验证 (30%) 集.
- 最小绝对收缩和选择运算符 (LASSO) 和多变量逻辑回归被用于识别SSD预测因子.
- 使用R软件构建了动态名ogram,通过ROC曲线,校准带和决策曲线进行评估.
主要成果:
- 对于SSD的关键预测因素包括年龄,饮酒史,C反应蛋白,APACHE II评分,尿道导管,机械通风,脑血管疾病,呼吸衰竭,约束,德克斯梅托米丁和普罗波.
- 在训练组中,名图实现了0.902的曲线下的面积 (AUC),在验证组中达到0.888.
- 该模型显示了良好的校准和显著的临床实用性,如决策曲线分析所示.
结论:
- 动态诺米图表表现出强大的预测性表现,用于ICU患者的子综合征性妄想.
- 这种工具对于医疗保健专业人员早期识别和管理SSD是精确和有效的.
- 诺米图表有助于及时干预,有可能改善ICU环境中的患者护理和结果.
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