建立儿童冲击指数的值,以识别重大创伤
Sriram Ramgopal1, Jillian K Gorski1, Pradip P Chaudhari2
1Division of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Injury
|August 28, 2024
概括
根据年龄调整的新冲击指数 (SI) 切断点显示,识别主要儿科创伤的灵敏度略有增加. 然而,单独的SI在诊断儿童严重受伤时的效用有限.
科学领域:
- 儿科急诊医学 儿科急诊医学
- 创伤重症监护中心的重症监护中心.
- 生理监测是指对身体进行生理监测.
背景情况:
- 异常冲击指数 (SI) 与儿科创伤患者的损伤严重程度增加有关.
- 现有的SI标准可能无法准确识别儿童的重大创伤.
研究的目的:
- 实证地推导出年龄调整的SI切断点,用于识别儿童的重大创伤.
- 将这些新的切断点的诊断准确性与现有的儿科SI标准进行比较.
主要方法:
- 使用2021年国家创伤数据库 (NTDB) 进行的回顾性队列研究.
- 包括受伤的儿童 (<18岁),但不包括特殊的重症监护病例.
- 使用年龄调整的Z分数和在2019年NTDB中验证的SI切割点的实证推导.
主要成果:
- 在验证样本中,经验推导的年龄调整的SI切割点显示了43.2%的灵敏度和79.4%的特异性.
- 性能指标 (灵敏度,特异性,AUROC) 与现有的措施,如儿科SI (PSI) 和儿科调整SI (SIPA) 相当.
- 高或低的年龄调整SI显著增加了重大创伤的几率.
结论:
- 根据年龄调整的SI切割点在检测主要儿科创伤的灵敏度上提供了微不足道的改善.
- 冲击指数,单独使用时,在全面识别儿童重大创伤方面发挥的作用有限.
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