开发和评价一个动态的血谱模型,用于手术内输血决策
Min Li1, Wei Jiang2, Jialing Lin1
1Department of Blood Transfusion Medicine, Sichuan Tianfu New Area People's Hospital, Chengdu, China.
Frontiers in medicine
|June 30, 2025
概括
一个新的动态名录模型使用患者数据准确地预测了手术内输血概率. 这种工具有助于外科医生及时做出输血决策,优化患者护理和节约血液资源.
科学领域:
- 麻醉学和外科手术期间的医学.
- 输血医学 输血医学
- 医疗信息学和预测建模
背景情况:
- 术内输血非常重要,但需要谨慎管理,以确保患者的安全和资源的优化.
- 预测需要手术期间输血是复杂的,通常依赖于主观的临床判断.
- 开发客观,数据驱动的工具可以增强输血医学中的决策过程.
研究的目的:
- 开发一个动态的nomogram决策模型来预测手术内输血概率.
- 确定影响手术患者需要手术内输血的关键因素.
- 为提供个性化和精确的输血指导提供一个工具,帮助及时的临床决策和节约血液资源.
主要方法:
- 一项回顾性研究收集了1410名手术患者 (2019-2023) 的数据,其中包括705名接受手术内输血和705名对照患者.
- 拉索回归和二元逻辑回归被用来确定手术内输血的独立风险因素.
- 使用R统计软件构建了一个动态名录模型,数据分为80%的培训和20%的测试集.
主要成果:
- 确定的关键预测因素包括ASA (III),手术分级 (IV),估计的血液损失 (EBL),手术前血红蛋白 (preHGB),左心室喷射分数 (LVEF),温度 (Temp),激活的部分血栓形成时间 (preAPTT) 和D-二次体 (preDD).
- 诺米图模型显示出优异的区分,训练组的曲线下面面积 (AUC) 值为0.983,测试组的值为0.995.
- 该模型表现出良好的校准,预测的概率与观察到的概率密切一致,并显示出显著的临床效用.
结论:
- 一个动态的诺莫格拉姆模型有效地根据已识别的风险因素预测了手术内输血的概率.
- 该模型提供实时,个性化的输血概率估计,协助外科医生及时作出明智的决策.
- 这种预测工具支持精确的血液管理策略,有助于改善患者的治疗结果和有效利用血液资源.
相关概念视频
Physiological Pharmacokinetic Models: Blood Flow-Limited Versus Diffusion-Limited Models
156
Physiological pharmacokinetic models, often called flow-limited or perfusion models, typically assume a swift drug distribution between tissue and venous blood, creating a rapid drug equilibrium. This premise is based on the idea that drug diffusion is extremely fast, and the cell membrane presents no barrier to drug permeation. In this scenario, where no drug binding occurs, the drug concentration in the tissue equals that of the venous blood leaving the tissue. This greatly simplifies the...
156
Blood Transfusion
820
Blood transfusion is a critical medical procedure that saves lives and treats various medical conditions. It involves transferring blood from a donor to a recipient. This process requires a thorough understanding of the ABO blood group system and its associated antigens and antibodies.
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...
820
Pharmacokinetic Models: Comparison and Selection Criterion
153
Physiological and compartmental models are valuable tools used in studying biological systems. These models rely on differential equations to maintain mass balance within the system, ensuring an accurate representation of the dynamic processes at play.
Physiological models take a detailed approach by considering specific molecular processes. They can predict drug distribution, metabolism, and elimination changes, providing a comprehensive understanding of how drugs interact with the body.
Physiological models take a detailed approach by considering specific molecular processes. They can predict drug distribution, metabolism, and elimination changes, providing a comprehensive understanding of how drugs interact with the body.
153
Pre-Procedural Guidelines for Assessing Blood Pressure
635
Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the...
635
Two-Compartment Open Model: IV Infusion
339
A two-compartment model is a vital tool in pharmacokinetics, providing an essential understanding of drug behavior, especially for those administered via zero-order intravenous infusion. This model outlines two compartments: the central compartment, where elimination occurs, and the peripheral compartment.
The model illustrates the decrease in plasma drug concentration from the central compartment with a specific equation. It shows that under steady-state conditions, the drug's input rate...
The model illustrates the decrease in plasma drug concentration from the central compartment with a specific equation. It shows that under steady-state conditions, the drug's input rate...
339
Blood Transfusion and Agglutination
11.3K
Blood transfusion is a therapeutic measure to restore the blood volume after extensive blood loss due to an accident or a medical procedure. Blood transfusion involves drawing a certain amount of blood from a suitable donor and infusing it into the recipient.
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
11.3K


