AMPREDICT流动性-4:一个新的四类流动性结果预测模型,用于进行血管截肢的患者
Daniel C Norvell1, Joseph M Czerniecki1, Alison W Henderson2
1VA Puget Sound Health Care System, Seattle, WA, USA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA; VA Centre for Limb Loss and Mobility (CLiMB), Seattle, WA, USA.
概括
一个名为AMPREDICT Mobility-4的新模型预测了下肢截肢后的功能性移动性. 它有助于外科医生和患者理解结果,并做出有关截肢水平的明智决策.
科学领域:
- 整形外科 整形外科 整形外科
- 血管外科 血管外科
- 康复医学 康复医学 康复医学
背景情况:
- 由于血管病因的下肢截肢 (LLA) 需要准确的移动性结果预测.
- 现有的模型可能无法充分捕捉不同截肢水平的功能恢复细微差别.
研究的目的:
- 开发和验证AMPREDICT移动-4模型,用于预测截肢后的功能移动性.
- 根据预测的流动性结果,协助关于截肢水平的共享决策.
主要方法:
- 追溯和前性队列研究,对704名患者进行了转移关节,关节或关节截肢.
- 利用电子健康记录数据,包括人口统计,并发症和健康行为.
- 使用多项逻辑回归和变量选择的拉索来预测截肢后12个月的四个移动水平.
主要成果:
- 在AMPREDICT流动性-4模型中,确定了功能流动性的15个预测因素.
- 该模型在轮椅流动性和社区行走能力 (c-index=0.71) 之间进行了良好的区分,以及高级与不到高级的社区流动性 (c-index=0.73).
- 家庭和基本社区流动性之间的歧视不那么精确.
结论:
- AMPREDICT Mobility-4有效地使用易于获得的数据预测不同LLA级别的功能移动性.
- 该模型增强了患者-外科医生沟通和对截肢后移动性的期望设置.
- 它支持个性化决策,用于截肢水平的选择.
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