预测严重疾病后的长期身体,精神和认知问题的预测:PROSPECT预测模型的开发和外部验证
Dries van Sleeuwen1,2, Marieke Zegers2, Jordache Ramjith3
1Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
Critical care medicine
|December 15, 2023
概括
早期识别有长期身体,精神和认知问题的风险的重症监护室 (ICU) 幸存者至关重要. 采用入院后48小时内数据开发的PROSPECT模型准确地预测了这些ICU后的健康问题.
科学领域:
- 关键护理医学 关键护理医学
- 健康 结果 研究 研究 结果
- 预测分析是一种预测分析.
背景情况:
- 重症监护室 (ICU) 的幸存者在出院后经常经历持续的身体,精神和认知障碍.
- 早期识别高风险患者对于在ICU住院期间及时进行干预至关重要,以减轻长期后果.
研究的目的:
- 开发和验证一个预测模型,用于在ICU入院后48小时内早期识别高风险出现ICU后健康问题的患者.
主要方法:
- 一项前性队列研究,涉及7个荷兰ICU的2,476名成年患者.
- 使用在ICU入院后48小时内收集的数据开发预测模型,包括患者记录和问卷.
- 预测身体,精神或认知问题的PROSPECT模型在ICU后3个月的内部和外部验证.
主要成果:
- PROSPECT模型结合了COPD,入院类型,预期的ICU停留时间以及入院前的焦虑/疲劳等预测因素,显示出强大的预测性能.
- 内部验证结果显示C统计值为0.73 (95% CI,0.70-0.76).
- 在另外六家医院进行的外部验证,C-统计结果为0.77 (95% CI,0.73-0.80).
结论:
- PROSPECT模型是一个经过验证的工具,用于识别ICU患者在ICU后三个月患有健康问题的风险增加.
- 早期应用PROSPECT模型 (在ICU入院后48小时内) 便于在ICU住院和后续护理期间及时进行预防性干预.
- 这种方法可以帮助预防或减少高风险人群中ICU后健康问题的严重性.
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