巴茨手术感染风险 (B-SIR) 工具:外部验证和与现有的工具进行比较,以预测心脏手术后手术部位感染
R Magboo1, J Cooper2, A Shipolini3
1St Bartholomew's Hospital, Barts Health NHS Trust, London, UK; William Harvey Research Institute, Queen Mary University of London, London, UK.
The Journal of hospital infection
|December 2, 2024
概括
巴茨手术感染风险 (B-SIR) 工具在预测心脏手术后手术部位感染 (SSI) 方面表现出优异的外部有效性,与澳大利亚临床风险指数 (ACRI) 和布朗普顿和哈尔菲尔德感染评分 (BHIS) 相比. 这表明B-SIR.
科学领域:
- 心血管外科心血管外科
- 传染病流行病学 传染病流行病学
- 临床风险预测建模模型
背景情况:
- 手术部位感染 (SSI) 是心脏手术后的一个严重并发症.
- 准确的风险预测工具对于患者管理和资源分配至关重要.
- 之前的研究证实了巴茨手术感染风险 (B-SIR) 工具的内部有效性.
研究的目的:
- 通过外部验证B-SIR工具来预测心脏手术后的SSI.
- 将B-SIR工具的预测性能与澳大利亚临床风险指数 (ACRI) 和Brompton和Harefield感染评分 (BHIS) 进行比较.
主要方法:
- 针对接受心脏手术的成年患者前性收集数据的多中心回顾性分析 (2018年1月 - 2019年12月).
- 曲线下的面积 (AUC) 用于评估和比较预测准确性.
- 霍斯默-莱梅肖测试和校准图片被用于校准评估.
主要成果:
- B-SIR工具的AUC值为0.686,明显高于BHIS (AUC=0.610) 和ACRI (AUC=0.614) (P<0.001) 的AUC值.
- 在重新校准后,B-SIR工具提供了准确的风险预测 (Hosmer-Lemeshow测试P=0.423).
- B-SIR工具的性能与其开发数据一致.
结论:
- 与ACRI和BHIS相比,B-SIR工具在预测心脏手术后的SSI方面表现出更高的外部有效性.
- 这些发现支持B-SIR工具在常规临床实践中的潜在实用性.
- 外部验证证实了B-SIR在各种医疗保健环境中的有效性.
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