败血症查工具的性能特征在分娩期间的入院
Elliott K Main1, Matt Fuller, Vesela P Kovacheva
1Department of Obstetrics and Gynecology, Stanford University, Palo Alto, the Sutter Health Institute for Advancing Health Equity and the Center for Health Systems Research, Sutter Health, Sacramento, Common Spirit Health, the Department of Systems Clinical Informatics, Common Spirit Health, and the Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, California; the Department of Anesthesiology and the Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina; the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts; the Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas; the Department of Obstetrics and Gynecology and the Department of Anesthesiology, Baylor College of Medicine, Houston, Texas; Wayne State University School of Medicine, Wayne, and the Department of Obstetrics and Gynecology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan; and the Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami, Florida.
加州孕产妇质量护理协会 (CMQCC) 和英国产科监测系统 (UKOSS) 的查工具在分娩期间诊断败血症方面表现出卓越的性能. 这些工具提供了最低的错误阳性率,同时保持了对败血症检测的高灵敏度.
科学领域:
- 产科和妇科 产科和妇科
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 败血症是一种危及生命的疾病,可以在分娩期间发生.
- 精确和及时诊断败血症对于有效治疗和改善患者结果至关重要.
- 现有的败血症查工具需要对其在产科人群中的表现进行评估.
研究的目的:
- 评估现有工具的查性能特征,用于在分娩入院期间诊断败血症.
- 为了比较多重败血症查标准的敏感度和错误阳性率.
主要方法:
- 一项用59家医院的电子健康记录数据进行的病例控制研究.
- 在分娩期间患有败血症的患者与对照组相匹配.
- 评估的查标准包括CMQCC,SIRS,MEWC,UKOSS和MEWT.
- 分析被分为分层分成有和没有胆膜炎-子宫内膜炎的队列.
主要成果:
- 在没有膜炎-子宫内膜炎的情况下,CMQCC和UKOSS表现出最低的假阳性率 (6.9%和9.6%) 和最高的C统计率 (0.92和0.91).
- 尽管SIRS和MEWC的敏感度相似,但错误阳性率显著高.
- 尽管存在膜炎-子宫内膜炎,但CMQCC和UKOSS仍然产生了最高的C-统计数据 (0.67和0.64).
结论:
- 根据CMQCC和UKOSS的妊娠调整标准在分娩入院期间对败血症查是有效的,提供低错误阳性率和高灵敏度.
- 所有评估的败血症查工具的性能在胆膜炎-子宫内膜炎的存在下降.
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