从重症监护室转移出来的患者睡眠障碍的预测模型:开发和验证
Wenjie Huang1, Xiuxiu Song2, Yang Gao3
1Medical School of Nantong University, Nantong, China.
Nursing in critical care
|February 20, 2025
概括
这项研究开发了一种预测模型,用于在重症监护室 (ICU) 退院后识别患有睡眠障碍高风险的患者. 早期识别和干预可以改善患者的治疗结果和生活质量.
科学领域:
- 关键护理医学 关键护理医学
- 睡眠医学 睡眠医学
- 医疗信息学 医疗信息学
背景情况:
- 睡眠障碍是重症监护综合征 (PICS) 的常见并发症.
- 睡眠障碍会对患者的康复产生负面影响,增加感染,再入院和死亡率.
- 对ICU后睡眠障碍的预测建模仍然是一个研究不足的领域.
研究的目的:
- 在ICU后的患者中识别睡眠障碍的危险因素.
- 建立和验证睡眠障碍的预测模型.
- 为早期干预和预防提供临床工具.
主要方法:
- 一组405名ICU患者被分为建模 (n=270) 和内部验证 (n=135) 组.
- 使用了一个由67名ICU患者组成的外部验证组.
- 风险因素被确定使用单变量和LASSO回归,其次是二进制逻辑回归. 匹兹堡睡眠质量指数 (PSQI) 评估了睡眠质量.
- 使用R语言开发了一个预测模型,并使用ROC和Hosmer-Lemeshow (H-L) 测试进行验证.
主要成果:
- 关键预测因素包括医院前睡眠障碍,高APACHE II分数,中度/重度并发症,雷米芬坦尼尔使用,低RCSQ分数和抑郁症.
- 该模型在建模组中显示出强大的预测性能,AUC为0.916 (灵敏度为81.9%,特异性为96.0%).
- 内部验证显示AUC为0.896,外部验证显示AUC为0.739,所有组的HL测试结果都很好.
结论:
- 一个经过验证的风险预测模型有效地识别了在ICU后有睡眠障碍风险的患者.
- 该模型以风险组图或名图形式可视化,有助于临床医生评估风险并实施有针对性的干预措施.
- 基于这种模式的积极护理干预可以改善ICU出院后的患者结果和生活质量.
相关概念视频
Substance Use Disorders Affecting Sleep
155
Substance use disorders involve a pattern of using drugs more extensively than intended and continuing use despite harmful consequences. This includes legal substances like alcohol and nicotine, as well as illegal drugs. These disorders often involve both physical and psychological dependence, reflecting compulsive use of substances that significantly alter thoughts, feelings, and behaviors, contributing to a major public health issue.
Understanding the concepts of physical dependence,...
Understanding the concepts of physical dependence,...
155
Management of Insomnia
229
The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
229
REM Sleep Behavior Disorder
130
REM Sleep Behavior Disorder (RBD) is a sleep disorder characterized by the absence of muscle paralysis that normally occurs during the REM phase of sleep. This absence allows individuals to physically act out their dreams, which are often vivid and disturbing. Common behaviors exhibited during episodes include kicking, punching, and yelling. These actions can be dangerous, potentially leading to injuries for the person with RBD or their bed partner.
RBD is significantly associated with...
RBD is significantly associated with...
130
Sleep Apnea
121
Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
The condition is more prevalent among...
121


