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开发一个预测模型的外科手术或早期死亡率在初始评估时为死角性肠球炎

Sujir P Nayak¹, Mariela Sánchez-Rosado^1,2, Jordan D Reis^1,3

¹Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas.

American journal of perinatology

|January 25, 2024

概括

一个新的HASOFA评分准确地预测了哪些患有死性肠球炎 (NEC) 的早产婴儿将需要手术或死亡. 这种经过验证的模型改进了NEC早期风险评估的现有方法.

科学领域:

新生儿医学新生儿医学
儿科手术儿科手术
关键的护理关键的护理

背景情况:

死性肠球炎 (NEC) 是早产婴儿的一种严重疾病.
目前的评估工具缺乏预测外科NEC或死亡率的准确性.
准确的预测对于及时干预和改善结果至关重要.

研究的目的:

开发和验证一个新的预测模型,用于手术NEC第三阶段或住院死亡率.
为了比较新的HASOFA得分与nSOFA得分的预测性能.

主要方法:

对261名怀疑或确定的NEC的早产婴儿进行了回顾性队列研究.
哈索法得分的发展 (高血糖症,高血症,低血压的异型药物,酸性血症,nSOFA).
内部验证HASOFA模型并与nSOFA模型进行比较.

主要成果:

与nSOFA (AUC 0.825) 相比,HASOFA模型显示了对NEC第三阶段或死亡 (AUC 0.909) 的手术预测优越.
将HASOFA与腹部红疹或门气等临床症状相结合,进一步提高了预测准确度 (AUC高达0.956).
81名婴儿 (31%) 经历了主要结果 (NEC III手术或死亡).

结论:

内部验证的HASOFA得分准确地预测了哪些早产婴儿需要为NEC第三阶段进行手术,或者有高死亡风险.
这种新模式为NEC管理中的早期风险分层提供了更好的歧视.
在初步评估NEC时,HASOFA评分为临床决策提供了有价值的工具.

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