PIM2,乳酸和创伤评分用于预测严重疾病儿科创伤患者的死亡率
Luciana G Barcellos1, Fernanda M Rubin1, Ana Paula P da Silva1
1Hospital de Pronto Socorro de Porto Alegre, Pediatric Trauma Intensive Care Unit, Porto Alegre, RS, Brazil.
Jornal de pediatria
|February 3, 2026
概括
儿科死亡率指数2 (PIM2) 和血清乳酸是重症儿科创伤患者死亡率的强有力的预测指标. 儿科创伤评分 (PTS) 一旦重症监护开始,效果就会降低.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 创伤外科 手术 创伤外科
- 预测模型的预测建模
背景情况:
- 儿科创伤是儿童死亡的主要原因.
- 准确的预后工具对于管理重症儿科创伤患者至关重要.
- 在这个人群中,PIM2,乳酸和PTS的预后值需要进一步评估.
研究的目的:
- 评估PIM2,血清乳酸和PTS的预后性能,以预测重症儿科创伤患者的死亡率.
- 为了比较巴西PICU队列中这三个标记物的预测准确性.
主要方法:
- 回顾1495名儿童创伤患者的病例系列,这些患者被录取到巴西的第三级创伤医院PICU (2018年3月至2025年3月).
- 收集的数据包括PIM2,初始乳酸和PTS.
- 用ROC曲线分析和后勤回归来评估死亡率预测.
主要成果:
- 整体的PICU死亡率为1.5%.
- PIM2显示了最高的预测准确性 (AUC 0.93),其次是乳酸 (AUC 0.86) 和PTS (AUC 0.82).
- 在多变量分析中,PIM2和乳酸是死亡率的显著独立预测因素.
结论:
- PIM2和血清乳酸是重症儿科创伤患者死亡率的有价值的独立预测因素.
- 与PIM2和乳酸相比,PTS在重症监护环境中的预后价值有限.
- 这些发现可以帮助儿童创伤患者的风险分层和临床决策.
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