在手术前选择性手术患者中开发和验证与药物有关的风险预测工具 (mediPORT):病例对照研究
Stephanie Clemens1,2,3, Clara Simon1, Wanda Lauth4
1Institute of Pharmacy, Pharmaceutical Biology & Clinical Pharmacy, Paracelsus Medical University Salzburg, Salzburg, Austria.
PloS one
|September 2, 2025
概括
一个新的手术前风险预测工具 (mediPORT) 识别了可能出现药物相关问题 (DRP) 的患者. 这种工具有助于医院的入院人员精确地确定高危人群进行关键药物评估.
科学领域:
- 药理学
- 患者安全
- 卫生信息学
背景情况:
- 药物相关问题 (DRP) 在术前护理中存在重大风险,可能会危及患者的治疗结果.
- 积极识别易受DRP影响的患者对于有效的手术前治疗至关重要.
研究的目的:
- 开发和验证一个名为mediPORT的手术前风险预测工具,用于计算入院患者的DRP概率.
- 在手术前的设置中确定DRP的关键预测因素.
主要方法:
- 一项病例对照研究包括18岁以上的选择性手术患者,他们正在接受药物评估.
- 使用后向渐进后勤回归来确定重要的DRP预测因子.
- 使用接收器操作特征曲线 (AUC) 下的面积和通过十倍交叉验证的内部验证来评估模型性能.
主要成果:
- 该研究分析了11,176名参与者,确定了284例DRP和980例对照.
- DRP的主要预测因素包括年龄,药物数量,体重指数,性别和功能.
- 一个两变量模型 (年龄,药物数量) 的AUC为0.872,而一个五变量模型的AUC为0.823,具有良好的验证灵敏度和特异性.
结论:
- 开发的mediPORT工具利用已识别的预测因子,可以有效地根据DRP风险对手术前患者进行分层.
- 医院入院可以利用这些预测方程来识别需要仔细药物评估的高风险患者.
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