对预测患有流感类疾病的患者并发症的工具进行系统审查
Tania Marx1, Nada Khelifi1, Isabelle Xu1
1Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec-Université Laval, Québec, Qc, Canada.
Heliyon
|January 1, 2024
概括
对类似流感的疾病并发症的预测工具显示出希望,但需要改进. 目前的CURB-65和qSOFA等分数尚未可靠用于广泛的急诊室使用,需要进一步开发.
科学领域:
- 临床医学 临床医学
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 类似流感的疾病 (ILI) 在门诊和急诊室 (ED) 设置中构成了重大挑战.
- 准确的风险分层对于管理潜在并发症和优化患者护理至关重要.
研究的目的:
- 系统地识别和评估用于预测患者的并发症的工具.
- 评估现有得分和模型在医院住院或死亡风险分层方面的表现.
主要方法:
- 在主要数据库 (Medline,Embase,Cochrane Library,CINAHL) 进行了全面的文献搜索,截至2023年7月.
- 包括的研究报告了ED或门诊诊所ILI患者的预测得分/算法的导出或验证.
- 确定并分析了12篇文章,详细介绍了8个分数和6个预测模型.
主要成果:
- 几项评分显示了住院预测准确度中等至良好 (AUCs从0.62到0.94) 和死亡率 (AUCs从0.66到0.86).
- 值得注意的分数包括PMEWS,CURB-65,SIRS标准和qSOFA.
- 像CovHos和加拿大Covid排放等较新的得分在COVID-19大流行期间显示出潜力,但需要外部验证. 预测模型通常表现良好,但需要进一步验证.
结论:
- 虽然CURB-65,PMEWS和qSOFA在预测ILI并发症方面表现出准确性,但它们缺乏广泛采用ED的可靠性.
- 现有的工具需要改进,或者需要开发新的工具来改善ILI患者的管理.
- 进一步的研究是必不可少的,以提高临床实用性预测工具的ILI.
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