验证两种评分工具,以预测创伤患者脏清理增加的风险
Julie E Farrar1, Joseph M Swanson1, Joanna Q Hudson1
1Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy, Memphis, Tennessee.
The Journal of surgical research
|June 14, 2024
概括
在重症创伤患者中,ARCTIC评分和ARC预测器有效地识别了增强清除 (ARC). 这些工具有助于识别常见的条件,通常被标准方程遗漏.
科学领域:
- 药理动力学和药物新陈代谢
- 关键护理医学 关键护理医学
- 腎臟病學 (nephrology) 是一種醫學.
背景情况:
- 增加干净度 (ARC) 在创伤患者中很常见,但通常不会被标准的功能方程识别.
- 准确识别ARC对于在重症患者群体中适当的药物剂量至关重要.
研究的目的:
- 评估ARCTIC评分和ARC预测器在重症创伤患者中识别ARC的有效性.
- 将这两种新的评分系统的预测性能与传统方法进行比较.
主要方法:
- 一个1级创伤中心的回顾性研究包括患重病的成年创伤患者,24小时收集尿液.
- 排除标准包括肌含量升高,脏替代疗法,腹肌溶解,CKD或尿液收集不准确.
- 敏感度,特异性,PPV,NPV和ROC曲线均为ARCTIC得分和ARC预测器计算.
主要成果:
- 在ARCTIC得分显示89%的灵敏度和54%的特异性;ARC预测器显示77%的灵敏度和88%的特异性.
- 无论是ARCTIC评分≥6和ARC预测值>0.5都是ARC的显著风险因素,特别是在TBI,肥胖,高ISS和负平衡的患者中.
- ARC预测值>0.5为预测ARC的几率比率 (20.07) 较高,与ARCTIC得分≥6 (8.59) 相比.
结论:
- 北极点数和ARC预测器是有效的工具,用于识别患有ARC高风险的重症创伤患者.
- 这些务实的预测工具可以帮助临床医生识别ARC,这通常被标准的功能估计遗漏.
- 需要进一步的研究来探索这些得分所识别的ARC相关的临床结果.
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