在老年人中进行干预前风险评估 (PIRATE):开发一个评分系统,使用老年人期间干预结果研究数据来预测30天死亡率
Alina Schenk1, Ana Kowark2,3, Moritz Berger1
1Department of Medical Biometry, Informatics and Epidemiology, Faculty of Medicine, University of Bonn, Bonn, Germany.
PloS one
|December 21, 2023
概括
一个新的风险评估工具,PIRATE,识别了接受手术的老年患者 (≥80岁) 的30天死亡预测因素. 该工具有助于对高风险患者进行分层,以便更好地做出决策.
科学领域:
- 老年医学 老年医学
- 手术风险评估手术风险评估
- 麻醉学 麻醉学
背景情况:
- 由于越来越多的老年患者接受手术,因此需要进行严格的风险评估.
- 现有的风险评分往往缺乏老年人 (≥80岁) 的特异性.
研究的目的:
- 开发一种易于使用的风险评估工具,用于预测在麻醉下进行干预的老年患者 (≥80岁) 的30天死亡率.
- 为了确定这一人口群体中死亡率的干预前预测因素.
主要方法:
- 考克斯回归分析被用来确定预测因素.
- 一个评分系统,PIRATE (Peri-Interventional风险评估工具) 已经开发和内部验证.
- 使用了来自欧洲多中心观察前性队列研究 (POSE) 的数据.
主要成果:
- 盗版工具包含三个预测指标:紧迫性,严重性和生活条件.
- 该工具表现出良好的区分能力 (一致性指数:0.75) 和低预测误差 (布里尔分数:0.036).
结论:
- PIRATE是一个易于获得,易于使用的工具,用于对干预后死亡风险增加的老年患者进行分层.
- 该工具适用于各种设置,手术类型 (可选/紧急,住院/每日病例) 和干预尺度 (小/主要).
- 皮拉特可以支持多学科团队为老年手术患者做出明智的共享决策.
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