在肺切除患者中建立和验证术后持续咳的风险预测模型:系统性审查和基于元分析的方法
Lei Ye1, Guanghui Xia1, Guanghong Wu1
1Department of Nursing, Nanjing Chest Hospital, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.
Journal of thoracic disease
|August 14, 2025
概括
这项研究开发了一种预测模型,以识别患有肺切除后持续术后咳风险的患者. 早期发现有助于有针对性的预防,改善患者的康复和生活质量.
科学领域:
- 胸部外科手术 胸部外科手术
- 肺部医学 肺部医学
- 临床预测建模 临床预测建模
背景情况:
- 手术后咳是肺切除后的常见并发症,对患者的康复和生活质量产生负面影响.
- 识别患有持续咳高风险的患者对于及时实施预防策略至关重要.
- 这项研究的重点是开发肺切除后持续咳的预测工具.
研究的目的:
- 开发和验证一个预测模型,用于识别患有肺切除后持续咳风险的患者.
- 在临床实践中建立一个可靠的工具,用于早期风险分层.
- 通过为咳预防提供有针对性的干预措施,改善患者的治疗结果.
主要方法:
- 进行了系统审查和元分析,以确定持续咳的危险因素.
- 使用聚合风险估计作为系数构建了一个预测模型.
- 该模型的预测准确性使用294名患者的数据进行了评估,并通过后勤回归验证.
主要成果:
- 分析包括13项研究,包括3669名患者;1115人患有慢性咳.
- 确定了七个显著的预测因子:叶切除术,右侧手术,右上叶切除术,下淋巴结解剖,支气管树淋巴结解剖,长时间的气管管道输管 (≥172分钟) 和酸性反流.
- 该模型实现了ROC曲线下的面积为0.87,灵敏度为0.735和特异性为0.849,切线为23.25.
结论:
- 开发了一种经过验证的肺切除后持续咳的预测模型.
- 该模型表现出强大的预测性能,为临床风险评估提供了有价值的工具.
- 这种工具可以帮助早期识别有风险的患者,促进个性化管理策略.
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