基于系统性免疫炎症指数和老年患者的预后营养指数的新型肺炎得分
Xiaofei Chen1, Zhijia Zhao1, Yi Liang1
1Department of Respiratory and Critical Care Medicine, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, China.
Frontiers in medicine
|January 21, 2026
概括
系统性免疫炎症指数 (SII) 和预后营养指数 (PNI) 评分模型可以帮助预测社区获得性肺炎 (CAP) 的老年重症监护室 (ICU) 患者的30天死亡率. 该工具有助于评估患者的风险,以改善临床管理.
科学领域:
- 关键护理医学 关键护理医学
- 老年医学 老年医学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 入住重症监护室 (ICU) 的社区获得性肺炎 (CAP) 的老年患者面临高死亡率.
- 评估免疫反应,炎症负担和营养状况对于预测这些患者的结果至关重要.
研究的目的:
- 开发和验证一个结合系统免疫炎症指数 (SII) 和预后营养指数 (PNI) 的评分模型,用于预测老年ICU患者的30天死亡率.
- 用内部和外部验证队列来评估模型的性能.
主要方法:
- 使用了密集护理IV (MIMIC-IV) 数据库和外部医院队列的医疗信息中心.
- 通过ROC分析在培训队伍中推导SII和PNI的最佳值,以创建SII-PNI得分.
- 使用后勤回归,卡普兰-梅尔分析和决策曲线分析验证了模型的预测值.
主要成果:
- 确定了最佳SII (2030.28) 和PNI (29.07) 值,证明了30天死亡率的预测值 (OR:2.19).
- SII-PNI得分显示了培训,内部验证和外部验证队列的显著预后表现.
- 与得分为0或1的患者相比,SII-PNI得分为2的患者的30天死亡率显著更高.
结论:
- SII-PNI评分模型显示出作为评估老年ICU患者30天死亡风险的辅助工具的承诺.
- 这种评分系统可以帮助临床医生分层风险,并可能指导这种脆弱患者群体的治疗决策.
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