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对IMPROVE风险评分用于预测住院COVID-19患者出血的外部验证

Yuzhi Tao^1,2, Feiya Xu³, Jing Han⁴

¹The First Bethune Hospital of Jilin University, Jilin University, Changchun, China.

Journal of general internal medicine

|February 20, 2025

概括

该IMPROVE出血风险评分有效预测住院COVID-19患者的大型出血. 这种工具有助于指导低分子量肝素血栓预防的决策,特别是对于老年人.

科学领域:

内部医学内部医学
关键护理医学关键护理医学
心脏病学心脏病学

背景情况:

COVID-19患者面临高血栓形成和出血的风险.
目前还没有标准化工具来评估这些患者的出血风险.

研究的目的:

评估IMPROVE出血风险评分 (BRS) 对住院COVID-19患者主要出血事件的预测能力.
评估分数在指导血栓预防策略中的表现.

主要方法:

一项前性多中心队列研究包括3886名住院COVID-19患者.
在90天内,IMPROVE BRS被评估为其对重大出血 (MB) 和临床相关的非重大出血 (CRNMB) 的预测值.
统计分析包括危险比率 (HRs),预测值和接收器操作特征曲线 (AUC) 下的面积.

主要成果:

IMPROVE BRS显示了MB事件 (AUC=0.84) 的强大预测性能和良好的校准.
高风险患者的出血风险显著增加,即使调整为低分子量肝素 (LMWH) 血栓预防.
在高风险的老年患者中,LMWH血栓预防与MB风险增加有关.

结论:

IMPROVE BRS在预测COVID-19患者的主要出血风险方面是有效的.
该得分为LMWH血栓预防提供了宝贵的指导,特别是在老年COVID-19患者中.
建议在不同种群中进行进一步验证,并改进值.

关键词:

在 COVID-19 疫情中,出血风险发生出血的风险临床预测模型外部验证验证

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