构建一个Nomogram模型,以估计在重症监护病房的老年患者中风扇相关肺炎的风险
Wensi Gan1,2, Zhihui Chen3, Zhen Tao4
1Department of Infection Control, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou 325001, China.
Advances in respiratory medicine
|February 23, 2024
概括
一种新的诺米图有效预测老年ICU患者的呼吸器相关肺炎 (VAP) 风险. 这种工具有助于对高风险个体的早期检测和干预,改善患者的治疗结果.
科学领域:
- 关键护理医学 关键护理医学
- 传染病流行病学 传染病流行病学
- 医疗信息学 医疗信息学
背景情况:
- 呼吸机相关肺炎 (VAP) 对老年重症监护室 (ICU) 患者构成重大风险,包括死亡率和长期住院.
- 目前缺乏准确的VAP风险评估工具,这阻碍了及时干预.
- 这项研究解决了对可靠方法的需求,以评估这种脆弱人群中的VAP风险.
研究的目的:
- 开发和验证用于预测老年ICU患者的VAP风险的诺米克图.
- 能够及早识别高风险个体,采取积极的保护措施.
- 加强临床决策和患者管理策略.
主要方法:
- 分析了293名老年ICU患者 (2016年1月至2021年3月) 的回顾性培训组和84名患者 (2021年4月至2022年2月) 的验证组.
- 最小绝对收缩和选择运算符 (LASSO) 和多变量后勤回归确定了关键预测因素.
- 构建了一个名图,并对校准,区分 (AUC 0.937/0.925) 和临床实用性 (DCA) 进行了验证.
主要成果:
- VAP风险的关键预测因素包括低蛋白血症,长时间使用抗生素,输管时间,机械通风时间和气管切除术.
- 在训练和验证队列中,名图显示出强大的预测性能,曲线下面积 (AUC) 值高.
- 校准和决策曲线分析证实了名图的准确性和临床适用性.
结论:
- 开发了一种新型名谱,可以准确预测老年ICU患者的VAP风险.
- 这种工具使医疗保健专业人员能够及早识别有风险的患者.
- 基于名谱预测的积极干预可以减轻VAP发生率并改善患者的治疗结果.
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