开发和验证癌症和中性衰竭发烧患者预后风险评分,向急诊室提交
Sandy Nath1, Aiham Qdaisat2, Andriy Derkach3
1Emergency Care Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
概括
一个新的客观风险评分准确地预测了急诊部中性衰竭发烧 (NF) 患者的不良结果. 这种工具有助于临床决策,可以减少患有NF的癌症患者不必要的住院治疗.
科学领域:
- 在瘤学瘤学.
- 紧急医疗 紧急医疗
- 临床风险分层的临床风险分层
背景情况:
- 中性衰竭发烧 (NF) 是一种严重的瘤紧急情况,患病率和死亡率很高.
- 现有的NF风险评分缺乏客观性,已经过时,在急诊室 (ED) 中的使用有限.
研究的目的:
- 开发和外部验证一个务实的,客观的风险评分,用于预测癌症患者呈现NF的ED的不良结果.
主要方法:
- 一项回顾性队列研究利用了来自两个主要癌症中心的数据来得分导出和外部验证.
- 主要综合结局包括ICU入院,细菌病,氧气治疗,长时间住院 (>3天) 和住院死亡率.
- 预测者被确定并根据多变量逻辑回归模型分配分数.
主要成果:
- 该研究包括827名患者在衍生队列和777名患者在验证队列.
- 开发的风险得分在导出和验证队列中达到0.77的AUC和0.78,表明了良好的预测性能.
- 通过得分识别的低风险患者在两个队列中都有0%的住院死亡率和<2%的ICU入院率.
结论:
- 新的风险评分有效地分层了中性衰竭发烧的急诊室患者.
- 它的客观和易于获得的数据有助于实时实施,潜在地改善临床决策和减少住院治疗.
- 建议在各种临床环境中进行进一步的前性验证.
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