开发和内部验证时间到事件风险预测模型,用于选择性切除术后30天内出现重大医学并发症
Janny X C Ke1,2, Tim T H Jen1,2, Sihaoyu Gao3
1Department of Anesthesiology, Pharmacology & Therapeutics, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.
PloS one
|December 2, 2024
概括
这项研究开发了时间到事件模型,以预测胆管切除术后的重大并发症,使得在高风险时期能够对患者进行有针对性的监测. 这些模型旨在通过在手术后确定特定并发症时间来改善患者的治疗结果.
科学领域:
- 手术成果研究的研究结果.
- 医学中的预测建模.
- 医疗服务研究 医疗服务研究
背景情况:
- 大肠切除术患者面临严重的并发症风险.
- 目前的模型缺乏对特定并发症的预测时间.
- 预测并发症时间对于有效的患者监测至关重要.
研究的目的:
- 开发和验证考克斯的比例危险模型.
- 为了预测大结肠切除术后30天内主要不良事件的并发时间.
- 为了实现对高风险患者的有针对性的监测.
主要方法:
- 美国外科医生学院国家外科质量改善计划数据集的回顾性队列分析.
- 包括接受选择性切除术 (2014-2019) 的成年患者.
- 根据文献和专家共识选择预测因素;结果包括死亡率,再接收和特定疾病.
主要成果:
- 对不同的并发症观察到不同的时间模式,例如,出血 (中位数为1天) 与静脉血栓塞栓症 (中位数为12天).
- 对死亡率,心肌梗塞,肺炎和功能衰竭的模型显示出良好的区别 (一致性> 0.8).
- 再入院,静脉血栓栓塞和败血症的模型表现中等 (一致性为0.6-0.7).
结论:
- 开发了内部验证的事件预测模型,用于结肠切除术后的并发症.
- 这些模型在进一步验证后,可以促进个性化监测策略.
- 在高风险时期进行量身定制的监测可以优化资源配置和患者护理.
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