开发和验证用于预测败血症患者的败血症诱导凝血病的诺姆图:混合回顾和前性队列研究
Yuting Li1, Liying Zhang1, Youquan Wang1
1Department of Critical Care Medicine, The First Hospital of Jilin University, Changchun, Jilin, China.
Thrombosis and haemostasis
|July 3, 2024
概括
一种新的血红图有效地预测了ICU患者使用冲击,血小板和INR的败血症诱导的凝血病 (SIC). 这种工具有助于早期识别和管理SIC,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
- 血液学 血液学 血液学
- 临床预测模型临床预测模型
背景情况:
- 败血症引起的凝血病 (SIC) 是重症监护室 (ICU) 患者预后不佳的重要预测因素.
- 目前的诊断工具缺乏在败血症患者中早期预测SIC的特异性.
- 需要可访问的工具来预测败血症患者的SIC发生情况.
研究的目的:
- 开发和验证用于早期识别败血症患者SIC的预测性名录.
- 将临床标记和评分系统用于个人SIC概率预测.
- 评估开发的诺莫图的临床实用性和净益处.
主要方法:
- 使用了回顾性发展队列 (n=548) 和前性验证队列 (n=245).
- 进行了单变量和多变量逻辑回归分析以确定预测因素.
- 该名录被验证为歧视 (AUROC) 和校准,并进行决策曲线分析.
主要成果:
- 最终的脑电图包括冲击,血小板和国际正常化比率 (INR) 作为预测因素.
- 冲击,较高的INR和较低的血小板显著与增加SIC概率有关.
- 该名录显示了良好的区分 (AUROC 0.879在开发中,0.872在验证中) 和校准.
结论:
- 一个经过验证的纳米图,包括冲击,血小板和INR,可以准确地预测败血症患者的SIC.
- 与现有策略相比,这种工具提供了更好的净收益.
- 建议进行进一步的外部验证,以提高可通用性.
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