在1级创伤患者中预测医院肺炎风险:使用创伤质量改善计划进行外部验证研究
Tim Kobes1, Ander Dorken-Gallastegi2, Anne-Sophie C Romijn3
1Department of Orthopaedic Surgery, Harvard Medical School Orthopedic Trauma Initiative, Massachusetts General Hospital, Boston, MA, USA; Department of Trauma Surgery, University Medical Center Utrecht, PO Box 85500, 3508GA Utrecht, the Netherlands.
American journal of surgery
|October 8, 2024
概括
克罗斯模型有效地识别了患有医院肺炎和呼吸机相关肺炎 (VAP) 风险的创伤患者. 这个工具可以指导预防措施,以减少创伤中心的感染率.
科学领域:
- 创伤护理 创伤护理
- 传染病流行病学 传染病流行病学
- 临床预测模型临床预测模型
背景情况:
- 早期识别患有临床肺炎风险的患者对于实施预防措施至关重要.
- 这项研究验证了美国一级创伤中心的医院肺炎预测模型.
研究的目的:
- 为了对外验证Croce等人. 医院肺炎的预测模型.
- 评估模型在预测创伤患者的全院肺炎和呼吸机相关肺炎 (VAP) 的性能.
主要方法:
- 使用TQIP全国创伤注册 (2013-2015年和2017-2019年) 的回顾性队列研究.
- 包括接受美国一级创伤中心治疗的患者.
- 在重新校准之前和之后评估模型的区分和校准.
主要成果:
- 这项研究包括超过90万名创伤患者.
- 克罗斯模型显示差别很好或很好 (c-统计值为0.84和0.92).
- 再校准提高了分辨能力和校准,特别是对于较低的预测概率.
结论:
- 克罗斯模型有效地识别了患有医院肺炎和VAP风险的创伤患者.
- 该模型的实施可以指导创伤临床实践中的预防策略和资源配置.
- 这可能会降低高危人群中医院肺炎的发病率.
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