预测性营养指数的预测性死亡率与APACHE II评分相结合,用于严重疾病的结核病患者
1Department of Intensive Care Unit, The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, Nanjing, China.
通过结合预后营养指数 (PNI) 和APACHE II分数,预测严重肺结核患者的30天死亡率得到了改进. 这种新的PA3模型为风险评估和降低死亡率提供了更有效的工具.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 医学预测 医学预测
背景情况:
- 重症结核病患者的高死亡率往往与当前预后工具的局限性有关.
- 开发更有效的预后评估方法对于降低这一脆弱人群的死亡率至关重要.
研究的目的:
- 为结核病重症患者确定有效的预后评估工具.
- 开发和验证一个预测模型,用于30天的死亡风险在重症监护室 (ICU) 结核病患者.
主要方法:
- 对115名入住ICU的重症结核病患者进行了回顾性分析.
- 使用单变量和最小绝对收缩和选择操作员 (LASSO) 回归分析来识别风险因素.
- 开发了一个预测模型 (PA3),将预测营养指数 (PNI) 和第三天的APACHE II分数结合起来.
主要成果:
- 第三天的PNI和APACHE II分数被确定为30天死亡率的独立风险因素 (P <0.05).
- 与单个分数相比,组合的PA3模型显示出明显更高的预测准确性 (AUC = 0.952).
- 开发的模型是如下表达的:PA3 = APACHE II评分 (3日) × 0.421 - PNI × 0.204.
结论:
- 在急症监护室入院后的第三天,PNI和APACHE II分数的结合提供了对重症结核病患者30天死亡风险的可靠预测.
- PA3模型为预后评估提供了一个有价值和改进的工具,可能有助于及时干预和降低死亡率.
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