构建一个预测模型,用于在门诊访问期间接受后腰部减压和融合内部固定手术的患者的高手术内过度出血
Zhenmin Sun1, Nan Yang1, Lei Wang2
1Department of Transfusion, Peking University Third Hospital, Beijing, China.
Clinical biochemistry
|December 3, 2024
概括
这项研究开发了一个名图,用于预测后腰部融合患者的高手术内出血风险. 早期风险评估有助于个性化治疗计划,以改善外科手术的结果.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 麻醉学 麻醉学
- 手术风险评估手术风险评估
背景情况:
- 后腰部减压和融合内部固定手术存在重大手术内出血的风险.
- 准确预测出血风险对于有效的医院前血液管理和改善患者结果至关重要.
研究的目的:
- 为在接受后腰部减压和融合内置固定手术的患者中构建高手术内出血的风险预测模型.
- 为在门诊环境中进行临床使用开发一个名图,以评估个体出血风险.
主要方法:
- 从2016年至2021年进行两段和三段后腰部减压和融合内部固定的患者的回顾性分析.
- 后勤回归被用来确定预测因素,包括激活的部分血栓形成时间,外科医生体积,美国麻醉学会分类,体重指数和融合部分的数量.
- 构建了一个名ogram,并对其预测性能进行了验证.
主要成果:
- 预测模型实现了接收器运行特征曲线下的面积为0.723 (95%CI:0.685-0.760).
- 决策曲线分析表明,值概率在5%至40%之间具有临床效用.
结论:
- 一种新型的诺摩图表在预测后腰部融合手术的高手术内出血风险方面表现出很好的准确性.
- 这种工具有助于门诊诊所的临床医生制定个性化治疗策略,潜在地减少出血并发症.
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