验证了三种模型,用于预测剖腹产期间输血的入院情况
Ann M Bruno1, Jerome J Federspiel2, Paula McGee3
1Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah.
American journal of perinatology
|December 22, 2023
概括
在美国的一项研究中,预测剖腹产期间输血的三个模型表现中等. 临床采用应优先考虑易用性,直到开发出优异的预测模型.
科学领域:
- 产科和妇科 产科和妇科
- 输血医学 输血医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在分娩入院期间预测输血需求对于临床准备和降低风险至关重要.
- 现有的预测模型需要外部验证来评估它们在现实世界中的适用性.
- 剖腹产是常见的产科手术,其中输血预测特别重要.
研究的目的:
- 在接受剖腹产分娩的美国队列中,外部验证了三种已建立的输血预测模型.
- 为了比较一个分类风险工具 (CMQCC) 和两个回归模型 (Ahmadzia等人,Albright等人) 的预测性能.
- 为临床实践提供有关选择适当的输血预测工具的信息.
主要方法:
- 一个多中心随机试验的二次分析,涉及接受剖腹产的个体.
- 在回归模型中应用CMQCC风险分层工具和计算曲线下的面积 (AUC).
- 模型校准的评估和回归模型输出的统计比较.
主要成果:
- 在10,785人中,3.9%的人接受了红细胞输血.
- 该CMQCC工具将个人分为低 (2.1%输血),中等 (2.2%输血) 和高 (7.5%输血) 风险组.
- 阿马兹亚和奥尔布赖特模型的AUC分别为0.78和0.79,校准良好.
结论:
- 这三种模型在该剖腹产分娩队伍中显示出适度的外部有效性来预测输血.
- 目前,对于临床使用的模型选择,应优先考虑易于应用.
- 需要进行进一步的研究,以开发在剖腹产期间输血的更高预测准确度的模型.
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