心血管外科手术后术后 Delirium 的预测模型:系统性审查和批判性评估
Yike Wang1,2, Xuling Zhao3, Xiaodi He1,2
1Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Nursing in critical care
|January 15, 2026
概括
现有的心血管外科手术术后痴呆症预测模型显示出良好的歧视性,但存在高偏差风险. 目前的模型不推用于临床使用,因为效用和通用性不确定.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 医疗信息学 医疗信息学
背景情况:
- 心血管外科手术的术后妄 (PODOCVS) 会增加并发症和死亡率.
- 通过预测模型的早期识别可以改善结果.
- 现有模型的质量和适用于心血管外科 (CS) 患者的适用性尚不清楚.
研究的目的:
- 系统地审查和批判地评估PODOCVS.的预测模型.
- 评估模型的发展,性能和适用性.
- 引导医疗保健专业人员选择合适的模型.
主要方法:
- 系统搜索多个数据库,截至2024年8月12日.
- 包括在成年CS患者中开发和验证PODOCVS多变量预测模型的研究.
- 使用CHARMS检查表和PROBAST工具进行质量评估.
主要成果:
- 24项研究描述了PODOCVS的67个预测模型.
- 妄想的发生率在3.6%至36%之间.
- 常见的预测因素包括年龄,EF值,绕道时间和ICU停留时间;物流回归是常见的.
结论:
- 模型显示出良好的区分能力,但偏差的风险很高 (PROBAST).
- 由于报告不足,在分析领域存在高或不明确的偏差风险.
- 实用性和通用性是不确定的;模型不建议用于临床使用.
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