老年关节骨折患者术后肺炎的预测模型:系统性审查和批判性评估
Zhiqiang He1, Gaoting Zhong1, Wenjin Han1
1School of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
Journal of clinical nursing
|January 14, 2025
概括
这一系统性审查发现,虽然预测模型可以在老年关节骨折患者中识别术后肺炎,但它们的质量和验证很差. 未来的研究必须优先考虑强大的外部验证和更新,以改善临床使用.
科学领域:
- 老年医学 老年医学
- 肺部病理学 肺部病理学
- 医疗信息学 医疗信息学
背景情况:
- 手术后的肺炎是老年关节骨折患者的一个重大问题.
- 现有的预测模型缺乏全面的质量和临床适用性评估.
- 需要进行系统审查来评估当前的预测模型.
研究的目的:
- 系统地审查和批判性地评估现有的模型来预测老年关节骨折患者的术后肺炎.
- 评估这些模型的质量,校准,验证和适用性.
主要方法:
- 一个系统的审查和对13项涉及25个预测模型的研究进行元分析.
- 在10个数据库中进行文献搜索,截至2024年4月.
- 独立评审人选择,数据提取和使用叙事综合和元分析进行质量评估.
主要成果:
- 肺炎的患病率为9.62%. 关键预测因素包括年龄,低蛋白血症,COPD,性别,ADL和ASA分数.
- 模型显示性能可变 (AUC 0.617-0.996),校准和验证不一致.
- 所有研究都表现出高偏差风险,尽管76.9%的研究具有良好的适用性.
结论:
- 在这个人群中,术后肺炎的预测模型是不发达的.
- 目前的模型存在着不良的验证和评估.
- 未来的研究应该强调强大的外部验证,更新和遵守TRIPOD+AI等报告准则.
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