摘要
目的系统评价老年髋部骨折术后死亡风险预测模型性能。方法检索维普、中国知网、万方、中国生物医学文献库(CBM)、PubMed、web of science、The Cochrane Library和Embase 8个数据库,检索时限均为建库至2023年4月10日。由2名研究者独立筛选文献和提取资料,并对纳入研究的文献采用PROBAST评估工具进行质量评价。结果纳入的14篇文献中共建立了17个老年髋部骨折术后死亡风险预测模型,其中16个模型的受试者工作特征曲线下面积(AUC)或C指数在0.72~1.00范围内。纳入研究的总体适用性高,但整体偏倚风险较高。预测模型中出现频率最高的预测因子有年龄、性别、白蛋白和美国麻醉师协会评分(ASA)分级。结论老年髋部骨折术后死亡风险预测模型预测性能较好,但质量较低,还处于发展阶段,未来研究需要从数据分析、数据来源和性能评价等多方面提高预测模型的质量,同时还需开展内部和外部验证,以检验其临床效能。
Objective To systematically evaluate the performance of mortality risk prediction models for elderly patients with hip fracture after surgery.Methods A total of 8 databases including VIP,CNKI,Wanfang,CBM,PubMed,web of science,The Cochrane Library,and Embase were searched,and the search time was from inception of the database to April 10,2023.The literature screening and data extraction were independently conducted by 2 researchers,and PROBAST evaluation tool was used to evaluate the quality of the literatures included the study.Results A total of 17 risk prediction models for postoperative death in elderly patients with hip fracture were established in the 14 included literatures,and the area under the receiver operating characteristic curve(AUC)or C-index of 16 models was in the range of 0.72-1.00.The overall applicability of the included studies was high,but the overall risk of bias was high.The predictors with the highest frequency in the prediction model were age,gender,albumin,and American Society of Anesthesiologists(ASA)score.Conclusion The prediction model of mortality risk after hip fracture surgery in the elderly has good prediction performance,but the quality is low and still in the development stage.Future research needs to improve the quality of the prediction model from the aspects of data analysis,data source,and performance evaluation.At the same time,internal and external validation is needed to test its clinical efficacy.
作者
陈旭
付红英
张永春
翟强鑫
江安琪
宋媛媛
CHEN Xu;FU Hongying;ZHANG Yongchun;ZHAI Qiangxin;JIANG Anqi;SONG Yuanyuan(Guizhou University of Traditional Chinese Medicine,Guiyang 550002,Guizhou,China;Guizhou Provincial People's Hospital,Guiyang 550002,Guizhou,China)
出处
《护士进修杂志》
2024年第20期2193-2200,共8页
Journal of Nurses Training
