为监禁成年人开发一种死亡率预测模型,以确定息治疗需求
W James Deardorff1,2, Alexandra K Lee3,4, Kaiwei Lu3,5
1Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA. william.deardorff@ucsf.edu.
Journal of general internal medicine
|December 18, 2025
概括
一个新的模型预测了被监禁成年人的2年死亡风险,有助于息治疗和同情释放转诊. 该工具有助于识别需要预先计划护理和专业医疗服务的个人.
科学领域:
- 公共卫生 公共卫生
- 老年学是一门学科.
- 犯罪学 犯罪学
背景情况:
- 准确的死亡风险估计对于被监禁的成年人来说至关重要.
- 识别需要缓和护理和同情释放的个人是公共卫生的优先事项.
研究的目的:
- 开发和内部验证被监禁成年人的2年死亡率预测模型.
- 加强临床决策的终身护理在惩戒设施.
主要方法:
- 从2018年2月1日到2020年2月1日进行了一项队列研究.
- 包括18岁或以上的被监禁成年人,居住在加利福尼亚州惩戒和康复部 (CDCR) 监狱至少1年.
- 使用考克斯比例危险回归与LASSO变量选择,评估人口统计,住房,功能状态,医疗保健利用率和慢性疾病.
主要成果:
- 该研究包括89,430名成年人,其中506名 (0.6%) 在2年内自然死亡.
- 该模型实现了0.926的接收器操作特征曲线 (AUC) 下的乐观度校正区域,表明了强大的预测歧视.
- 校准图表显示,预测和观察到的死亡率之间有很好的一致性,在临床相关值评估的特定绩效指标.
结论:
- 开发的死亡风险模型为临床医生提供了有价值的估计.
- 方便识别可能受益于事先护理计划的被监禁人员.
- 支持用于息护理服务和同情释放计划的转诊.
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