开发和验证多变量预测模型的复发和死亡率后非手术管理的西格体卷发症
Anthony Loria1, Xueya Cai2, Shan Gao2
1Surgical Health Outcomes and Research Enterprise (SHORE), Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA.
概括
一个新的工具预测了复发性西格体卷积和非手术治疗后的死亡风险. 这有助于老年人面临这种具有挑战性的疾病的临床决策.
科学领域:
- 胃肠病学和肝病学
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 西格体卷发症提出复杂的管理决策,平衡手术与非手术方法.
- 在初始非手术治疗后预测复发和死亡率对于患者护理至关重要.
研究的目的:
- 开发一种预测工具,以估计在一年内出现复发性西格卷发症的风险.
- 开发一种预测工具,在一年内估计所有原因死亡的风险.
- 帮助临床医生和患者做出明智的决定,以非手术方式治疗西格体卷发症.
主要方法:
- 使用医疗保险索赔数据 (2016-2018) 的回顾性队列研究.
- 包括患有西格体卷发症的患者,接受了非手术性结肠减压,并活着出院.
- 开发并验证了使用比例危险和物流回归的预测模型.
主要成果:
- 在2078名患者中,36.1%的患者出现了复发,28.6%的患者在一年内死亡.
- 复发预测模型 (AUC 0.63) 包括年龄,性别,种族,息治疗和并发症.
- 死亡率预测模型 (AUC 0.76/0.70) 包括年龄,息治疗和并发症.
结论:
- 使用可访问数据的一种简单的预测工具可以估计西格卷发症复发和死亡率的个性化风险.
- 该工具支持最初非操作管理的老年人的知情决策.
- 建议进行进一步的外部验证和前性研究,以提高临床效用.
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