使用验证的风险评分预测住院心脏评估对失眠的结果
Shir Frydman1, Ophir Freund2, Lior Zornitzki3
1Internal Medicine B, Tel-Aviv Sourasky Medical Center, Faculty of Medicine, Tel-Aviv University, Israel; Department of Cardiology, Tel-Aviv Sourasky Medical Center, Faculty of Medicine, Tel-Aviv University, Israel.
目前的昏迷风险得分在医院住院期间预测心脏昏迷原因的能力有限. 75岁以上的年龄和异常的心脏检查结果显著提高预测,当添加到现有的得分.
科学领域:
- 心脏病学 心脏病学
- 内部医学 内部医学
- 临床预测 临床预测
背景情况:
- 经验证的风险评分主要有助于医院入院决策.
- 它们在预测住院患者心脏评估结果中的实用性仍未得到充分研究.
研究的目的:
- 评估现有的风险评分对住院心脏评估结果的预测能力.
- 识别新型预测因素并改善现有得分,以更好地预测结果.
主要方法:
- 连续昏迷入院的观察性研究.
- 使用了长时间的心电图监测和心声回声.
- 使用曲线下面面积 (AUC) 评估风险评分表现,并通过多变量回归确定独立预测因素.
主要成果:
- 在397名患者中,有56名患者 (14%) 的住院心脏评估结果为阳性.
- 拉齐奥和加拿大风险评分显示AUC为0.70.
- 年龄≥75岁和心脏听异常是显著的独立预测因子 (OR分别为3.50和4.79).
- 包括这些因素在内的修改得分显示AUC有所改善 (0.787和0.778).
结论:
- 现有的昏迷风险评分为住院患者的心脏评估结果提供了有限的预测能力.
- 年龄>75岁和特定的体检结果 (声,心率不规则) 是心脏病因的关键指标.
- 从病史和体检中整合临床发现可以提高当前风险评分的表现.
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