在儿科心脏病重症监护病房患者中使用一种新的情境意识评分系统
Orkun Baloglu1,2, Kristopher Kormos2, Sarah Worley3
1Department of Pediatric Critical Care Medicine, Cleveland Clinic Children's, Cleveland, Ohio, United States.
Journal of pediatric intensive care
|December 4, 2024
概括
情境意识评分系统 (SASS) 有效地确定了重症监护病房中儿科心脏骤停 (CA) 的风险. 在4小时内SASS分数截止值为60显示出高灵敏度和特异性,用于预测CA事件.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 临床绩效测量 临床绩效测量
- 患者安全 患者安全
背景情况:
- 在儿科心脏重症监护室 (PCICU) 中的心脏骤停 (CA) 带来了重大挑战.
- 早期识别CA风险患者对于及时干预至关重要.
- 预测CA的现有方法可能缺乏足够的准确性或及时性.
研究的目的:
- 评估一种新型情境意识评分系统 (SASS) 在区分经历CA和没有经历CA的患者之间在PCICU中的表现.
- 确定SASS得分预测CA的最佳时间窗口.
- 评估SASS的敏感性和特异性,以识别CA高风险患者.
主要方法:
- 在四级护理PCICU进行的回顾性观察队列研究.
- 包括在2014-2018年间经历过CA的患者和2018年入院的非CA患者.
- 利用交叉验证的物流回归模型计算ROC曲线下的面积 (AUC) 计算SASS分数在CA之前的各种时间间隔内.
主要成果:
- 在CA之前的4小时间隔内的最大SASS得分达到0.91的最高AUC,表明强烈的歧视性表现.
- 在4小时内SASS分数截止值为60显示了CA预测的82.1%灵敏度和83.2%特异性.
- 在4小时内,每增加10个单位的最大SASS得分,与CA的概率增加1.32倍有关.
结论:
- 新型SASS在区分PCICU中CA风险患者方面显示出有前途的表现.
- 在CA之前的4小时时间间隔似乎是SASS应用最有效的窗口.
- SASS有可能成为儿童重症监护机构中早期发现和预防CA的宝贵工具.
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