一项回顾性病例对照研究,比较了2种阿片类药物风险减轻工具在非关键性,非手术性住院患者中
Kimm M Grafenreed-Freeman1, Paul Hughes2, Reem M Ghandour3
1Wellstar Cobb Hospital, Austell, GA, USA.
概括
在使用capnoGraphY (PRODIGY) 工具监测的患者中,密歇根阿片类药物安全评分 (MOSS) 比密歇根阿片类药物安全评分 (MOSS) 更敏感,用于识别患有阿片类药物诱导呼吸系统抑郁 (OIRD) 风险的住院患者. 这一发现支持PRODIGY的有效阿片类药物管理.
科学领域:
- 药理学 药理学是指药理学的学科.
- 患者安全 患者安全
- 临床风险评估临床风险评估
背景情况:
- 有效的阿片类药物管理需要准确的工具来识别有呼吸损害风险的患者.
- 在住院患者中,阿片类药物诱导的呼吸抑制 (OIRD) 是一个重大问题.
研究的目的:
- 为了比较密歇根阿片类药物安全评分 (MOSS) 和阿片类药物诱导的呼吸系统抑郁症的预测,在使用capnoGraphY (PRODIGY) 工具监测的患者中.
- 为了确定哪种工具更好地识别OIRD风险的非手术性,非危急性住院患者.
主要方法:
- 一项回顾性病例控制研究比较了暴露于阿片类药物的成年患者的MOSS和PRODIGY得分.
- 对这两种工具计算了灵敏度,特异性,ROC曲线和AUC.
- 如果患者被录入ICU,急诊室或产科,或者如果他们没有服用阿片类药物,则被排除在外.
主要成果:
- 在预测OIRD时,PRODIGY显示了86.62%的灵敏度和20.27%的特异性.
- MOSS显示了2.82%的灵敏度和100%的特异性.
- 在检测OIRD时,PRODIGY显著更敏感 (83.8%),而不是MOSS.
- 莫斯显然比普罗迪吉更具特异性.
- 曲线下的面积 (AUC) 是PRODIGY的0.59和MOSS的0.48.
结论:
- 对于识别OIRD风险的非临界,非手术性住院患者,PRODIGY工具比MOSS更为敏感.
- PRODIGY的更高的灵敏度表明,它是在这个患者群体中早期检测OIRD的更有效的工具.
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