重症监护病房获得性衰弱风险预测模型的构建
Construction of acquired weakness risk prediction model in intensive care unit
王灵 1龙登炎1
作者信息
- 1. 黔东南苗族侗族自治州人民医院重症医学科(邮编 556000)
- 折叠
摘要
目的 构建重症监护病房获得性衰弱(ICU-AW)的风险预测模型,指导临床预防及治疗.方法 纳入并分析重症医学科收治的1 063例患者的性别、年龄、年龄校正查尔森合并症指数(aCCI)、是否输注白蛋白、心力衰竭、是否行康复治疗、咪达唑仑用量、去甲肾上腺素用量、机械通气时间与ICU-AW的相关性,筛查独立危险因素并建立预测模型,分析模型的预测能力.结果 1 063例患者中发生ICU-AW 370例,Logistic回归分析显示高龄、高aCCI、长机械通气时间、高咪达唑仑用量、高去甲肾上腺素用量、心力衰竭为ICU-AW的独立危险因素,康复治疗及输注白蛋白为独立保护性因素;预测模型的回归方程为:Logit(P)=0.017×年龄+0.008×机械通气时间+0.006×去甲肾上腺素用量-0.832×康复治疗-0.648×输注白蛋白+1.224×aCCI+0.017×咪达唑仑用量+1.834×心力衰竭-6.806.模型的受试者工作特征曲线下面积(AUC)为0.908(0.890～0.925),敏感度为82.20%,特异度为82.40%.结论 利用上述变量构建的模型具有较好的预测效能,可为临床防治提供新思路.
Abstract
Objective To construct a risk prediction model for intensive care unit-acquired weakness(ICU-AW)to guide clinical prevention and treatment strategies.Methods The correlation between gender,age,age-adjusted Charlson Comorbidity Index(aCCI),injecting albumin,heart failure,rehabilitation treatment,midazolam dosage,norepinephrine dosage and mechanical ventilation duration in 1 063 patients admitted to the intensive care unit was analyzed.Independent risk factors were identified to establish the prediction model,and the predictive ability of the model was analyzed.Results Among 1 063 patients,370 developed ICU-AW.Logistic regression analysis identified advanced age,higher aCCI,prolonged mechanical ventilation duration,increased midazolam and norepinephrine dosages,and heart failure as independent risk factors for ICU-AW,while rehabilitation treatment and injecting albumin were identified as independent protective factors.The regression equation of the prediction model was:Logit(P)= 0.017×age + 0.008×mechanical ventilation duration + 0.006×norepinephrine dosage-0.832×rehabilitation treatment-0.648×injecting albumin + 1.224×aCCI + 0.017×midazolam dosage + 1.834×heart failure-6.806.The area under the curve(AUC)of the model was 0.908(0.890-0.925),with the sensitivity of 82.20%and specificity of 82.40%.Conclusion The model constructed using these variables demonstrates good predictive efficiency and can provide new insights for clinical prevention and treatment of ICU-AW.
关键词
重症监护病房获得性衰弱/临床预防及治疗/独立危险因子/预测模型Key words
intensive care unit-acquired weakness/clinical prevention and treatment/independent risk factors/predictive model引用本文复制引用
基金项目
黔东南州科技支撑计划(黔东南科合支撑[2021]12号)
贵州省科技支撑计划(黔科合支撑[2020]4Y139号)
贵州省高层次创新型人才培养项目(黔千层人才[2022]201701号)
出版年
2024
NETL
NSTL
万方数据