预测模型关于患者是否有资格接受腹膜透析
Yang Yang1, Helen H Chen1, Robert R Quinn2
1School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada.
概括
一个预测模型可以在开始血液透析 (HD) 后确定符合腹膜透析 (PD) 资格的患者. 这种工具有助于选潜在的PD候选人,改善治疗的可用性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 脏替代疗法治疗 脏替代疗法
背景情况:
- 腹腔透析 (PD) 提供了成本效益和与血液透析 (HD) 相似的结果.
- 评估PD的资格是主观的,并且在脏项目中存在很大差异.
- 准确的PD资格确定对于患者管理至关重要.
研究的目的:
- 开发一种预测模型,用于在患有HD的患者中预测PD的适宜性.
- 确定影响PD资格的关键预测因素.
- 评估符合条件的患者中从HD转变为PD的转变率.
主要方法:
- 在加拿大阿尔伯塔省 (阿尔伯塔省) 启动了598名患者的回顾性队列研究 (2016-2018).
- 逻辑回归建模结合了27个预测因素 (人口统计,实验室,并发症).
- 通过Akaike信息标准选择模型;使用混矩阵和ROC曲线评估性能.
主要成果:
- 65.4% (391/598) 的患者有资格获得PD.
- 预测模型表现出高灵敏度 (91.3%) 和中度准确度 (0.68).
- 降低PD资格的因素包括年龄较大,BMI较低,ICU启动和多囊性病.
结论:
- 大多数开始患HD的患者有资格获得PD.
- 开发的预测模型显示了对查PD候选人的高灵敏度HD启动后.
- 该模型可以帮助识别适合PD治疗的患者.
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