急性疾病期间的临床集群预测了老年患者的长期死亡率
A Tsui1,2,3, P Hogan4,5, H Cheston5
1Institute of Health Informatics, University College London (UCL), 222 Euston Road, London, NW12DA, UK. a.tsui@ucl.ac.uk.
BMC medicine
|December 30, 2025
概括
这项研究在老年人急性疾病期间确定了不同的患者亚型,改善了对大脑失补偿和死亡率的预测. 睡眠-清醒周期的干扰是妄想症的关键预测因素.
科学领域:
- 老年学是一门学科.
- 计算生物学 计算生物学
- 临床医学 临床医学
背景情况:
- 由于急性疾病的不补偿,老年患者缺乏个性化治疗方法.
- 多模式和高维数据为得出具有临床意义的患者集群提供了潜力.
- 这项研究探讨了急性疾病脱补偿的集群驱动和高维预测因素,包括大脑参与.
研究的目的:
- 测试该假设,即可以构建集群驱动和高维预测器用于临床部署.
- 为了获得对急性疾病脱补偿的病理生理学的机制性见解,特别是影响大脑.
- 改进对经历急性疾病的老年人不利结果的预测.
主要方法:
- 协调两个独立的前性队列研究 (DELPHIC和DECIDE) 进行培训和测试.
- 应用T-静态邻居嵌入和聚合层次聚类来识别患者亚型.
- 使用集群驱动和高维模型,与输入贡献分析的SHAP值进行脑损伤补偿和2年死亡率的预测性能比较.
主要成果:
- 在急性疾病期间,在老年人中确定了三种广泛的临床亚型,从基线和急性变量中作出贡献.
- 预测大脑脱补偿的接收器操作特征曲线 (AUROC) 下面的区域显著改善,从0.563 (基线) 到0.641 (集群驱动) 和0.797 (高维).
- 睡眠-觉醒周期的干扰被确定为妄想的主要预测因素;生理学波动,特别是认知,预测了长期的死亡率.
结论:
- 在急性疾病期间,对于老年患者来说,可以识别出强大,可泛化和临床有用的集群.
- 对于定义和建模急性疾病的纵向方法的概念验证的演示.
- 强调高维度和多模式在预测不良结果和识别睡眠-清醒周期障碍方面的潜力,作为妄想研究的关键目标.
相关概念视频
Classification of Illness
8.5K
The meaning of illness is individualized to each person who experiences an alteration in health. In contrast, disease is a medical term indicating a pathological change in the structure and function of the body or mind. It is a condition that has specific symptoms and boundaries.
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe...
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe...
8.5K
Factors Affecting Illness
5.0K
When a person's physical, emotional, intellectual, social development or spiritual functioning is compromised, this deviation from a healthy normal state is called illness. Illness creates stress that in turn harms individuals. Irritation, anger, denial, hopelessness, and fear are behavioral and emotional changes an individual experiences in the phases of illness. A variety of factors influence a person's health and well-being.
For instance, risk factors are connected to illness,...
For instance, risk factors are connected to illness,...
5.0K
Stages of Infection
64.7K
Stages of infection describe what happens to a susceptible host once a pathogen invades the human body. The stages of infection are incubation, prodromal, illness, stage of decline, and convalescence. The incubation stage is the period from exposure to a pathogen until symptoms start. The infected person is unaware of impending illness as the pathogens grow and multiply within the body. The duration may vary depending on the type of infection. The incubation period of measles averages ten to...
64.7K
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
216
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
216
Pneumonia II: Pathophysiology
2.5K
The pathophysiology of pneumonia involves the following steps:
2.5K
Acute Kidney Injury III: Clinical Manifestations
763
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
763

