非心脏手术后急性损伤的术前风险预测模型:一个独立的外部验证队列研究
Xiao-Yu Zhuo1, Shao-Hui Lei2, Lan Sun3
1Department of Anaesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, China; Guangdong Provincial Key Laboratory of Precision Anaesthesia and Perioperative Organ Protection, Guangzhou, China.
British journal of anaesthesia
|March 25, 2024
概括
这项研究验证了9个模型,在非心脏手术后预测急性损伤 (AKI). 三种模型在重新校准后显示了公平的歧视和临床实用性,为患者提供了更好的风险评估.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 外科手术的结果
- 预测建模预测建模
背景情况:
- 现有的非心脏手术急性损伤 (AKI) 预测模型缺乏独立的验证和比较分析.
- 这种差距阻碍了预测工具的可靠临床应用.
研究的目的:
- 系统地审查和外部验证已发表的非心脏手术的AKI风险预测模型.
- 用歧视,校准和临床效用指标来评估模型性能.
主要方法:
- 在非心脏外科手术中对AKI预测模型进行了系统的文献搜索.
- 在一个追溯的中国队列 (n=13,186) 上使用病改善全球结果标准进行了外部验证,用于AKI.
- 对歧视 (AUROC),校准和临床实用性 (净益处) 的评估模型,再校准前后.
主要成果:
- 评估了9个模型,其中3个显示公平歧视 (AUROC 0.71-0.75).
- 所有模型都显示出一些校准错误,但五个模型在重新校准后被校准得很好.
- 公平歧视的重新校准模型提供了积极的净收益,灵敏度分析证实了这一点.
结论:
- 确定了三种经过验证的模型,用于预测非心脏手术后AKI的公平歧视.
- 这些模型在重新校准后显示出潜在的临床实用性.
- 强调AKI预测模型的外部验证和重新校准的重要性.
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