预测ROX指数的性能及其对NIV故障的变化
Lada Lijović1, Tomislav Radočaj2, Nataša Kovač2
1Department of Intensive Care Medicine, Laboratory for Critical Care Computational Intelligence, Amsterdam Medical Data Science, Amsterdam Public Health, Amsterdam Cardiovascular Science, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Amsterdam, The Netherlands; Department of Anesthesiology, Intensive Care and Pain Management, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia.
罗克斯指数及其变异显示,在ICU患者中预测非侵入性通风 (NIV) 失败的适度能力. 目前的表现不足以支持预测输管风险的临床决策.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统生理学 呼吸系统生理学
- 医疗信息学 医疗信息学
背景情况:
- 非侵入性通风 (NIV) 是一种常见的ICU治疗方法.
- 预测NIV失败对于及时干预和改善患者结果至关重要.
- 现有的预测指数需要在大型,多样化的患者队列中进行验证.
研究的目的:
- 为了评估ROX指数及其变异 (mROX,ROX-HR,mROX-HR) 对NIV故障的预测性能.
- 在大型公共ICU数据库中评估这些指数.
- 确定它们在预测接受NIV的ICU患者输管风险方面的有用性.
主要方法:
- 使用阿姆斯特丹UMCdb和MIMIC-IV数据库进行的回顾性观察队列研究.
- 包括3344名非侵入性通风ICU患者.
- 在NIV的前12小时内,基于SpO2,呼吸速率,FiO2和PaO2计算的ROX指数.
主要成果:
- 罗克斯指数表现出最好的预测性能,在10-12小时的AUROC为0.626.
- NIV失败与更高的SOFA分数和CRP水平有关.
- 在失败和成功组之间没有观察到NIV持续时间或28天死亡率的显著差异.
结论:
- 在大型ICU队列中,ROX指数及其变异仅表现出NIV故障的中等预测值.
- 目前的性能水平不支持它们用于临床决策支持,用于预测输管.
- 可能需要进一步的研究来完善或识别更准确的NIV失败预测工具.
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