预测短期复诊的患者在急诊室呈现时的高风险回归:HANDLE-24得分
Chung-Ting Chen1,2,3, Po-Hsiang Liao1,2,4, Meng-Chen Lin5
1Emergency Department, Taipei Veterans General Hospital, Taipei, Taiwan.
BMC emergency medicine
|February 12, 2025
概括
HANDLE-24评分识别了在急诊室 (ED) 重访后患有不良结果的高风险患者,从而能够及时进行干预. 这个简单的工具有助于早期风险分层成年人返回ED.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健服务研究 医疗服务研究
- 临床信息学 临床信息学
背景情况:
- 72小时急诊室 (ED) 复诊率是一个关键的质量指标.
- 复诊可能是由于医疗错误,护理不足,疾病进展或获得医疗保健的限制.
- 需要一个风险评估工具来识别高风险患者并优化资源分配.
研究的目的:
- 开发和验证一种风险评估工具,用于预测高风险的72小时ED复查.
- 为了确定与ED重访时不良结果相关的关键因素.
- 为了使回归ED的患者能够进行早期风险分层.
主要方法:
- 使用台湾高等医疗中心电子健康记录进行的回顾性队列研究 (2019年1月 - 2020年12月).
- 使用后勤回归和引导方法来推导风险模型.
- 主要结局被定义为重症监护室 (ICU) 入院或在ED重访后72小时内住院死亡率.
主要成果:
- 开发了HANDLE-24评分,包括8个变量 (高血压,急性冠状动脉综合征症状,失血,呼吸不良,肝病,分拣升级,24小时复诊),
- 该模型表现出良好的预测性能,接收器操作特征曲线下的面积为0.816 (开发) 和0.804 (验证).
- 根据HANDLE-24得分,患者被分为低,中等和高风险组,显示出对入院,ICU入院和住院死亡率的显著预测.
结论:
- HANDLE-24评分是早期风险分层的简单而有效的工具,用于72小时ED复诊的患者.
- 它有助于识别那些可能受益于更积极的治疗策略的患者.
- 该得分利用易于获取的信息,快速评估返回ED患者的不良结果风险.
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