开发和验证一种风险评分,用于预测新发脑炎的成年人接受ICU的风险评分
Ralph Habis1, Ashley Heck2, Paris Bean2
1Department of Neurology, Johns Hopkins Encephalitis Center, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Meyer 6-160, Baltimore, MD, 21287, USA.
Neurocritical care
|July 31, 2024
概括
一个新的风险评分有助于预测脑炎患者的重症监护室 (ICU) 入院情况. 这种工具有助于医生确定最佳的护理水平,以获得更好的患者结果.
科学领域:
- 神经学 神经学
- 关键护理医学 关键护理医学
- 流行病学 流行病学
背景情况:
- 脑炎的诊断需要及时进入重症监护室 (ICU),以改善患者的预后.
- 对脑炎患者来说,最佳的管理和资源配置至关重要.
研究的目的:
- 开发和验证临床风险评分,用于预测被诊断患有脑炎的成年患者的ICU入院.
- 帮助医疗保健提供者在入院时做出有关护理强度的明智决定.
主要方法:
- 使用二进制逻辑回归模型,确定了372名脑炎患者 (第1队列) 接受ICU治疗的预测变量.
- 开发的风险评分被外部验证,使用一个单独的队列,包括262名脑炎患者 (队列2).
- 国际脑炎协会 (IEC) 的标准用于两组患者的选择.
主要成果:
- 在634名脑炎患者中,有40%需要接受ICU治疗.
- 进入ICU的关键预测因素包括焦点神经症状,新发作的,低的完全概述不响应 (FOUR) 评分 (≤14),白细胞病和慢性病.
- 风险得分显示出良好的预测性能,接收器操作特征曲线 (AUROC) 下的面积在初级队列中为0.77,在验证队列中为0.76.
结论:
- 患有脑炎的患者经常需要进入重症监护室,不论其根本原因是什么.
- 开发的风险评分,包括神经和系统因素,可以支持临床决策对脑炎患者的护理.
- 这种工具可能会增强用于脑炎管理的重症监护资源的适当分配.
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