动态血红图预测急性肝衰竭患者的败血症风险:与外部验证的重症监护数据库分析
Rui Qi1,2, Xin Wang2, Zhi-Dan Kuang2
1Peking University 302 Clinical Medical School, Beijing 100039, China.
World journal of gastroenterology
|September 3, 2025
概括
我们开发了急性肝衰竭性败血症 (SIALF) 模型来预测急性肝衰竭患者的败血症风险. 这种工具有助于早期检测和治疗高风险的败血症患者.
科学领域:
- 肝病学
- 危急护理医学
- 传染性疾病
背景情况:
- 急性肝衰竭 (ALF) 患者的败血症与快速进展和高死亡率有关.
- 在ALF患者中早期识别高风险败血症小组对于及时干预至关重要.
研究的目的:
- 为预测ALF患者的败血症风险开发和验证一个准确的诺姆图模型.
- 创建一个工具,以帮助早期发现和管理ALF的败血症.
主要方法:
- 使用了MIMIC IV和FMCPH数据库中的数据.
- 多变量逻辑回归在ALF中发现了独立的败血症风险因素.
- 使用内部和外部队列构建和验证了一个名图模型 (SIALF).
主要成果:
- 在SIALF模型中,年龄,总胆红素,乳酸脱酶,白蛋白和机械通风被确定为ALF感染的独立危险因素.
- SIALF模型显示出强大的预测准确性 (AUC 0.835- 0.849),表现优于SOFA和SIRS得分.
- 为了提高临床实用性,开发了SIALF模型的在线动态版本.
结论:
- 基于易于获取的临床数据的SIALF模型有效预测ALF患者的败血症风险.
- 与现有的评分系统相比,该模型表现优越,并经过外部验证.
- SIALF模型及其在线计算器可以促进早期毒症检测和针对性治疗ALF患者.
相关概念视频
Acute Kidney Injury III: Clinical Manifestations
90
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
90
Acute Kidney Injury I: Introduction
72
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
72
Acute Kidney Injury IV: Diagnostic Studies and Prevention
57
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
57
Acute Kidney Injury II: Pathophysiology
72
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
72
Acute Kidney Injury VI: Nursing Management
57
Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
57
Esophageal Varices-II: Clinical Features and Management
135
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
135


