社区老年人的死亡率预测模型:系统性审查
Collin J C Exmann1, Eline C M Kooijmans1, Karlijn J Joling2
1Department of General Practice, Department of General Practice, Amsterdam UMC, Meibergdreef 9 (Location AMC), Amsterdam 1105AZ, the Netherlands; Amsterdam Public Health research institute (Aging & Later Life), Meibergdreef 9 (Location AMC), Amsterdam 1105AZ, the Netherlands.
Ageing research reviews
|October 5, 2024
概括
预测老年人死亡率对于医疗保健至关重要. 这次对38个模型的审查发现了有希望的工具,但需要更多的研究才能可靠地在临床上使用.
科学领域:
- 老年学是指老年学的学科.
- 医疗保健服务研究 医疗服务研究
- 生物统计学 生物统计学
背景情况:
- 人口老龄化带来了复杂的医疗保健挑战,包括治疗决策和资源分配.
- 需要准确的死亡率预测模型来支持社区老年人的临床决策.
- 目前缺乏对现有的死亡率预测模型的系统概述.
研究的目的:
- 系统地审查和评估现有的所有原因死亡率预测模型,用于社区居住的老年人 (65岁及以上).
主要方法:
- 在四个数据库中进行了系统的文献搜索,直到2024年3月1日,使用与预测建模和老年人相关的术语.
- 包括的研究为社区居住的老年人开发了多变量全因死亡率预测模型.
- 数据提取遵循了CHARMS检查表,质量评估使用了PROBAST工具.
主要成果:
- 该审查从22项研究中确定了38个独特的死亡率预测模型.
- 模型包括基于赤字的累积脆弱性指数 (14 个模型) 和机器学习 (9 个模型).
- C-统计从0.60到0.93不等,其中8个模型超过0.8并报告校准. 常见的变量包括人口统计,症状,诊断和身体功能. 五项研究 (11个模型) 具有高偏差风险.
结论:
- 几种死亡率预测模型显示了老年人临床应用的潜力.
- 虽然许多研究具有足够的质量,但需要更多标准化的方法和外部验证.
- 需要进一步的研究,以确保这些预测工具的稳健的临床实施.
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