预测2019年新冠肺炎患者在重症监护室入院的预测因素
Lahib Douda1, Heraa Hasnat1, Jennifer Schwank2
1Department of Medical Education, Ascension Providence Hospital/Michigan State University College of Human Medicine, Southfield, Michigan, United States.
Avicenna journal of medicine
|May 2, 2024
概括
预测COVID-19患者进入重症监护室 (ICU) 的时间至关重要. 使用年龄,BMI,qSOFA分数和氧化率的模型可以识别高风险个体,帮助早期干预以获得更好的结果.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 进入重症监护室 (ICU) 的COVID-19患者的高死亡率需要ICU入院的预测标准.
- 识别患有2019年新冠肺炎疾病 (COVID-19) 的高风险的ICU入院患者对于资源配置和及时干预至关重要.
研究的目的:
- 开发和验证住院COVID-19患者ICU入院的预测模型.
- 确定与COVID-19患者ICU入院相关的关键临床因素.
主要方法:
- 对2020年3月至5月期间住院的1094名COVID-19阳性患者的电子医疗记录的回顾性审查.
- 开发一个多变量后勤回归模型,使用导出子集来预测ICU入院.
- 使用单独的验证子集验证预测模型的验证,并使用c-statistic评估性能.
主要成果:
- 18.6%的确诊的COVID-19患者需要接受ICU治疗.
- 对于ICU入院的重要预测因素包括年龄,体重指数 (BMI),快速序列器官衰竭评估 (qSOFA) 评分,动脉氧和与吸入氧的比例,血小板计数和白细胞计数.
- 预测模型在导出 (c-统计:0.798) 和验证 (c-统计:0.764) 子集之间显示出出色的可比性,在22%的预测概率值下,灵敏度为0.721和特异性为0.763.
结论:
- 一个试点预测模型结合了年龄,BMI,qSOFA得分和氧化状态,有效地识别了COVID-19患者在ICU入院的风险较高.
- 这些因素可以指导ICU入院的临床决策,潜在地改善患者管理和结果.
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