慢性肺病 (PRO-MEL) 的预后模型:开发和时间验证
Sheryl Hui-Xian Ng1, Zi Yan Chiam2, Gin Tsen Chai3,4
1Health Services and Outcomes Research, National Healthcare Group, Annex @ National Skin Centre, 1 Mandalay Road, Singapore, 308205, Singapore. Sheryl_hx_ng@nhg.com.sg.
BMC pulmonary medicine
|August 30, 2024
概括
一个新的预后模型预测慢性肺病 (CLD) 患者的一年死亡率. 这种工具有助于为患有恶化高风险的患者提供早期的息护理转诊.
科学领域:
- 肺部医学 肺部医学
- 老年病的医生 老年病的医生
- 抚慰性护理是一种缓解性护理.
背景情况:
- 慢性肺病 (CLD) 在晚期呈现出显著的症状负担.
- 对于CLD患者的息治疗转诊往往会延迟.
- 现有的预后工具可能缺乏跨不同类型的CLD的概括性.
研究的目的:
- 开发和验证一种通用预后模型,用于预测任何类型的结核病患者的一年死亡率.
- 改善早期识别需要息护理评估的CLD患者.
主要方法:
- 从2016年7月到2017年10月使用电子病历进行的回顾性队列研究.
- 开发和验证后勤回归模型,以预测诊断后一年内所有原因的死亡率.
- 缺少数据的多重归算和模型区分能力,校准和临床有用性的评估.
主要成果:
- 最终的模型是通过前进的逐步变量选择选择选择的,包括十个预后因素.
- 该模型表现出良好的区分能力,在开发队列中AUC为0.77 (0.72-0.82),在验证队列中为0.75 (0.70-0.81).
- 该模型在将预测死亡风险超过0.30的患者分类为高风险时,准确识别了30%的死亡者和90%的幸存者.
结论:
- 通过使用行政数据,开发了一种验证的CLD患者一年死亡率的预后模型.
- 该模型支持临床医生识别各种CLD病因的风险患者.
- 早期识别有助于缓解护理评估和及时转诊,解决未满足的患者需求.
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