评估MACOCHA评分来预测危急癌症患者难以输管的情况:一项前性观察性研究
Atul P Kulkarni1, Shilpushp J Bhosale1, Kushal R Kalvit2
1Department of Anesthesiology, Division of Critical Care Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumbai, Maharashtra, India.
概括
马可卡评分在预测严重病情患者难以进行气管内输管 (TI) 时表现出中度准确性. 需要进一步的研究来提高其预测能力,以获得更好的患者结果.
科学领域:
- 关键护理医学 关键护理医学
- 麻醉学 麻醉学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 气管输管 (TI) 是重症监护室 (ICU) 中的一个关键程序.
- 难以输管 (DI) 对重症患者构成重大风险.
- 马可卡得分是为了预测该人口的DI而开发的.
研究的目的:
- 为了评估 MACOCHA 评分在危急病患者队列中难以进行气管管道输入的预测性表现.
- 在ICU环境中评估MACOCHA得分的歧视和校准.
主要方法:
- 进行了一项前性,单中心的观察性研究.
- 包括500名在ICU接受TI的成年患者.
- 使用收集的人口,入院和输管数据计算了MACOCHA分数. 统计分析包括AUROC曲线和Hosmer-Lemeshow测试.
主要成果:
- 分析了449名患者的数据;13.5%的患者经历过DI.
- 马可卡分数显示了中度的歧视 (AUROC = 0.659) 和中度的校准 (p = 0.208).
- 常见的TI原因包括急性功能衰竭和休克. 在26.5%的患者中出现并发症.
结论:
- 马可卡得分显示,在危急病患者中,预测难以进行气管管道输入的能力中等.
- 评分的中度歧视和校准表明其当前应用的潜在局限性.
- 对ICU中DI的预测工具的进一步改进是有必要的.
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