开发和验证一个死亡风险预测指数得分的成年人与艾滋病毒和多种慢性并发症生活的成年人
Viviane D Lima1,2, Bronhilda T Takeh1, Neil Faught1
1British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.
International journal of population data science
|July 2, 2025
概括
一个新的死亡风险预测指数 (MRP) 有助于评估艾滋病毒感染者短期死亡风险 (PLWH). 这种工具有助于临床医生管理并发病症并改善抗逆转录病毒疗法 (ART) 上老化PLWH的健康结果.
科学领域:
- 老年学是一门学科.
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 由于慢性并发症的增加,艾滋病毒感染者的老龄化人口存在复杂的临床管理挑战.
- 准确的风险预测工具对于了解艾滋病毒感染者 (PLWH) 的疾病负担至关重要.
- 现有的指数可能无法完全捕捉PLWH在现代抗逆转录病毒疗法 (ART) 时代所面临的多方面的风险.
研究的目的:
- 开发和验证一种死亡风险预测指数 (MRP) 用于预测PLWH的一年全因死亡率.
- 确定导致这一群体死亡风险的关键并发症和临床因素.
- 为更好的临床决策和健康政策制定提供一个工具.
主要方法:
- 分析了2001年至2018年期间在加拿大不列颠哥伦比亚省开始接受ART的成年人 (≥18岁) 队列.
- 参与者在ART开始后至少被跟踪了一年,以评估所有原因的死亡率.
- 该MRP纳入了18种身体/精神并发症,人口统计和临床变量,范围从0 (无风险) 到100 (最高风险).
主要成果:
- 最终的MRP模型表现出强烈的歧视,其c-统计值为0.8355 (培训) 和0.7965 (测试) 数据集.
- 药物使用障碍,转移性固体瘤和非艾滋病定义的癌症是加权的共同疾病.
- 30的MRP得分预测了0.2%的一年死亡率,而50的得分预测了2.3%的死亡率.
结论:
- MRP是评估PLWH中短期死亡风险的验证工具.
- 它可以通过突出高风险个体和指导管理策略来告知临床实践.
- 该指数支持旨在改善ART上老龄化PLWH的医疗保健政策决策.
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