开发一个基于临床的预测模型,用于儿科内肠吸收:一个前性观察性研究
Dongbum Suh1, Jin Hee Lee2, Seongyeon Oh3
1Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
The Journal of emergency medicine
|September 13, 2025
概括
一个新的临床预测模型通过使用诸如发烧缺失和RUQ敏感等症状来识别患有肠接的儿童. 这种工具有助于及时做出超声波决定,在儿科患者怀疑腹腔内置.
科学领域:
- 儿科急救医学 儿科急救医学
- 临床预测建模临床预测建模
- 胃肠道紧急情况
背景情况:
- 肠接是一个严重的儿科疾病,导致肠道阻塞和缺血.
- 准确和及时诊断输入受是有效治疗的关键.
- 超声波是儿童内肠接的主要诊断工具.
研究的目的:
- 开发一个临床预测模型,用于输肠受.
- 该模型利用病史,症状和体检结果.
- 目标是确定需要超声波评估内肠接的儿科患者.
主要方法:
- 在儿科急诊室进行的前性观察研究.
- 包括年龄在6岁以下的儿童,怀疑患有内肠受精.
- 使用后勤回归来识别预测因素并开发模型,使用灵敏度,特异性,PPV,NPV和AUROC来评估诊断性能.
主要成果:
- 在83名患者中,34.9%的患者被诊断出患有内.
- 关键预测因素包括没有发烧 (aOR 4.4),间歇性腹痛/刺激性 (aOR 3.4),没有腹 (aOR 8.0) 和RUQ疼痛 (aOR 8.2).
- 该模型实现了66%的灵敏度,83%的特异性,68%的PPV,81.5%的NPV和0.78的AUROC,100%的灵敏度和NPV得分≥1.1.
结论:
- 一个基于特定症状的预测模型有效地识别了有风险的儿童.
- 该模型支持儿童患者的及时超声波决定,有模糊的腹部症状.
- 改进的诊断准确性可以导致更好的患者输入内的结果.
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