开发和验证低压暴露持续时间指数,用于预测重症患者的死亡风险
Xiao-Yan Ding1,2,3, Hai-Ping Xu4, Jing-Ru Zhang5
1Cardiovascular Intensive Care Unit, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Dongjie 134, Gulou District, Fuzhou, Fujian, China.
Journal of intensive care
|December 2, 2025
概括
一个新的低压暴露持续时间指数 (HEDI) 有效量化了重症监护中的累积低血压负担. 较高的HEDI得分预测了ICU死亡率的增加,在不同患者群体中得到验证.
科学领域:
- 关键护理医学 关键护理医学
- 心血管生理学心血管生理学
- 医疗信息学 医疗信息学
背景情况:
- 在重症监护机构中,有效的血压管理至关重要.
- 了解血压波动对患者结果的影响仍然是一个挑战.
- 一分钟一分钟的血压数据分析为新的见解提供了潜在的潜力.
研究的目的:
- 开发和验证一个新的指数来量化低血压暴露负担.
- 评估该指数用于预测ICU死亡率的预后价值.
- 评估指数在不同患者群体中的一致性.
主要方法:
- 来自萨尔茨堡重症监护数据库的11,059次ICU入院病例的回顾性分析.
- 使用高分辨率的血液动力学数据和机器学习开发低压暴露持续时间指数 (HEDI).
- 使用eICU数据库对HEDI进行外部验证.
主要成果:
- 与幸存者相比,未幸存者表现出明显更高的HEDI得分 (p < 0.001).
- 随着时间的推移,HEDI对死亡率的预测能力越来越强 (AUC从24小时的0.624到72小时的0.700).
- 机器学习模型,特别是额外树,以HEDI作为关键特征实现了高性能 (测试AUC:0.843).
结论:
- 低压暴露持续时间指数 (HEDI) 准确量化了重症患者累积的低压负担.
- 在ICU死亡率方面,HEDI显示出显著的预后能力.
- 该指数的有效性在各种患者群体中得到证实,包括使用血管压缩剂的患者.
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