开发和验证用于早期预测败血症引起的凝血病的诺米克图:一个多中心研究
Ruimin Tan1,2, Yi Zhou1,2, Shuwei Zhang1,2
1Department of Critical Care, Chongqing General Hospital, Chongqing, China.
Frontiers in medicine
|September 25, 2025
概括
这项研究开发了一种名目录模型,用于预测败血症患者的败血症诱导凝血病 (SIC) 风险. 该模型准确地识别了早期发病的SIC,有助于及时进行临床干预,并改善了患者的治疗结果.
科学领域:
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
- 生物统计学 生物统计学
背景情况:
- 败血症引起的凝血病 (SIC) 是一种严重的并发症,涉及血管内皮细胞损伤和凝血障碍.
- 早期识别SIC风险对于及时干预和改善患者预后至关重要.
- 预测SIC风险的现有方法需要提高临床应用.
研究的目的:
- 构建和验证一个名目录预测模型,用于早期发病的败血症诱导的凝血病 (SIC) 在败血症患者.
- 确定与医院内SIC发展相关的关键风险因素.
- 提供一种临床上适用的工具,用于SIC的个性化风险评估.
主要方法:
- 追溯分析了入住ICU的847名败血症患者,分为培训,测试和外部验证集.
- 利用后勤回归,LASSO回归和多因素后勤分析来选独立的风险因素.
- 构建了一个包含八个变量的诺莫格拉姆模型:乳酸,氧化指数,总蛋白质,总 bilirubin,尿素,素,激活的部分血栓形成时间和单细胞计数.
主要成果:
- 诺米克图模型表现出良好的预测准确性,AUC值为0.783 (训练),0.768 (测试) 和0.782 (验证).
- 确定的关键预测因素包括乳酸,氧化指数,总蛋白质,总白血素,尿素,素,活性部分血栓形成时间和单细胞计数.
- 该模型显示了高精度,良好的匹配 (校准曲线) 和显著的临床实用性 (DCA).
结论:
- 一个经过验证的诺莫格拉姆模型有效地预测了败血症患者早期发病SIC的风险.
- 诺米图表是个性化风险评估和及时干预的可靠临床工具.
- 可视化关键变量有助于临床医生管理毒症患者的血液凝固病风险.
相关概念视频
01:23Dosage Regimen Designs: Nomograms and Tabulations
181
Nomograms and tabulations are vital tools used by clinicians to design accurate and individualized dosage regimens. These instruments provide a straightforward method for adjusting dosages based on individual patient characteristics, including age, weight, and physiological condition. The foundation of a drug's nomogram is population pharmacokinetic data collected and analyzed using specific models. This data simplifies complex equations, presenting them diagrammatically or tabularly for easy...
181
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
260
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...
260