识别和预测即将死亡的综合征 (≤14天):一个系统性审查
Bernardo Rocha-Baião1, Paulo Reis-Pina2
1Center for Palliative Medicine, Faculty of Medicine, University of Lisbon, Lisboa, Portugal.
Journal of pain and symptom management
|January 29, 2026
概括
在14天内识别即将死亡综合征 (SID) 对于终身决策至关重要. 聚集的床边标志和生命体征是最有效的预测即将到来的死亡.
科学领域:
- 抚慰性护理是一种缓解性护理.
- 临床预测模型临床预测模型
- 在生命末期的护理.
背景情况:
- 准确地识别和预测即将死亡综合征 (SID) 对有效的生命终结 (EOL) 决策至关重要.
- 及时识别临近死亡的患者有助于护理规划和资源分配.
研究的目的:
- 系统地审查临床诊断方法的诊断和预后准确性,以识别或预测SID (在≤14天内死亡).
- 综合各种床边评估工具在预测短期死亡率方面的表现的证据.
主要方法:
- 在MEDLINE,科学网络和Scopus的全面文献搜索到2024年.
- 包括评估临床方法 (症状,生命体征,分数,临床医师估计,监测) 与在≤14天内观察到的死亡相比的研究.
- 使用GRADE-DTA对证据的叙述综合,偏差风险评估和确定性评估.
主要成果:
- 集群的迹象 (混乱,低血压,低SPO2,死亡声) 显示高PPV (≈95%) 死亡在48小时内.
- 特定的生命体征值 (例如,RR>28/分钟,HR ≥110/分钟) 和复合得分 (例如,GPS与血小板减少) 证明了预后价值.
- 一天和三天的惊喜问题 (SQ) 显示了预测短期死亡的良好的灵敏度和NPV;护士在预测方面表现优于医生.
结论:
- 临床临床方法,包括集群症状,生命体征切断和疾病背景,有效地支持短期SID识别.
- 格拉斯哥预测得分 (GPS) 和惊喜问题 (SQ) 等复合得分是有价值的辅助.
- 为了完善这些工具,需要使用标准化的预测视界和校准报告进行前性外部验证.
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