通过CHAT联盟对重症儿童静脉血栓风险模型的多站点验证
Julie Jaffray1, Brian R Branchford2, Maua Mosha Alleyne3
1Rady Children's Hospital, University of California, San Diego, San Diego, California, United States.
Blood
|November 24, 2025
概括
儿童血栓瘤医疗保健进展 (CHAT) 重症监护室 (ICU) 风险评估模型 (RAM) 有效地识别了危急病患有患医院相关静脉血栓塞栓症 (HA-VTE) 风险的儿童. 这种经过验证的工具有助于确定哪些儿科患者可以从血栓预防中受益.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 血液学 血液学 血液学
- 临床流行病学临床流行病学
背景情况:
- 重症儿童面临着与医院相关的静脉血栓塞栓症 (HA-VTE) 的重大风险.
- 经过验证的风险评估模型 (RAM) 对于识别可能受益于血栓预防的儿科患者至关重要.
研究的目的:
- 为了前性地验证儿童的医疗保健进展在血栓瘤 (CHAT) 密集护理科 (ICU) VTE RAM.
- 评估CHAT-ICU RAM在多中心儿科队列中的辨别能力和校准.
主要方法:
- 未来的多中心队列研究涉及4,674名儿童ICU患者,年龄为0-21岁.
- 验证了CHAT-ICU RAM,其中包括CVC,不运动,先天性心脏病,自身免疫/炎症状况和住院时间≥3天等变量.
- 使用接收器操作特征 (AUROC) 曲线和校准图表下的面积来评估模型性能.
主要成果:
- 在CHAT-ICU RAM中,AUROC为0.71 (95%CI:0.64-0.78) 的AUROC显示出良好的区分有效性.
- 该模型显示了良好的校准,校准斜率为1.0 (95%CI:0.87-1.14).
- 来自RAM的风险分数与HA-VTE的估计概率相关,范围为1%至17.4%.
结论:
- CHAT-ICU RAM是一个精心校准和有效的工具,用于识别患有HA-VTE高风险和低风险的儿科ICU患者.
- 这种风险评估模型可以可靠地指导对重症儿童血栓预防的决策.
- 这项研究证实了CHAT-ICU RAM在多中心儿科患者群体中的临床实用性.
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