摘要
目的建立和验证脓毒症患者预后评价的列线图评分系统,对患者的预后进行评估,以判断患者的严重程度。方法利用重症大数据库的临床资料,根据临床应用场景,选取脓毒症患者入住ICU后1 h内可以获得的临床指标,包括年龄和性别,生命体征资料,是否需要使用血管活性药物以及一小时内检测的血乳酸为预测因子,30天病死率为研究结局。使用logistic回归分析建立以列线图表示的临床预测模型,使用重复抽样法进行内部验证。结果建立了脓毒症30天死亡率预测的列线图模型,该模型的区分度C指数为0.759(95% CI:0.725~0.794),使用重复抽样方法的验证的区分度C指数为0.762(95% CI:0.728~0.797)。结论本研究利用建立的列线图模型对超早期判断脓毒症预后和严重程度有一定的临床参考意义。然而,模型仍需进一步验证。
Objective To establish and validate a nomogram scoring system to evaluate the severity of the sepsis patient.Methods Clinical application scenarios clinical data available within 1 hour of admission to the ICU was used to establish the nomogram scoring system.Clinical predictors included age,sex,vital signs,vasopressor use and lactate level within 1 hour.30-day mortality as an outcome.Logistic regression analysis model was used to determine independent risk factors and a nomogram was established to predict 30-day mortality.The validation was performed using repeated sampling method.Results A nomogram of 30-day mortality was established in sepsis patients with a C-index of 0.759(95%CI:0.725~0.794)and a validated discriminant C-index of 0.762(95%CI:0.728~0.797)using repeated sampling methods.Conclusion Nomogram model will clinically be relevant for ultra-early determination of prognosis and severity of sepsis and has clinical significance.However,this model needs to be further validated.
作者
杨其霖
梁文迪
谢富华
张振辉
熊旭明
陈伟燕
Yang Qilin;Liang Wendi;Xie Fuhua;Zhang Zhenghui;Xiong Xuming;Chen Weiyan(Department of Critical Care Medicine,Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China;Guangzhou Medical University,Guangzhou 510260,China)
出处
《中华临床实验室管理电子杂志》
2020年第3期145-149,共5页
Chinese Journal of Clinical Laboratory Management(Electronic Edition）
基金
广东省科技计划项目,编号:2014A020212325。
