为什么个别患者的并发症会累积

A. Sonnenberg
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引用次数: 0

摘要

似乎一个器官系统的衰竭会引发其他器官系统的后续衰竭。本分析的目的是模拟这样的系统行为,并了解为什么医疗并发症在个别患者中积累。人体首先被建模为由多个子系统组成,每个子系统的健康依赖于有关其自身健康状态和所有其他子系统健康状态的输入。在第二步中,离散模型被推广为连续模型,该模型通过一阶微分方程捕获系统故障和系统修复。失败近似于逻辑上的下降,修复近似于健康上的逻辑上的上升。单个子系统健康状况的小幅下降会扩散到整个系统,并影响整个系统的健康状况。除非通过治疗或修复措施加以抵消,否则任何与时间相关的单个子系统的健康损失都会导致整个系统的健康下降。治疗开始的延迟是影响健康总体累积衰退的最关键因素。该模型表明,医疗管理需要迅速,以尽量减少疾病对整个身体的累积时间依赖性。
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Why do Complications Accumulate in Individual Patients
It appears as if the failure of one organ system precipitates the subsequent failure of other organ systems. The aim of the present analysis is to model such system behavior and understand why medical complications accumulate in individual patients. The human body is first modeled as being comprised of multiple subsystems, with the health of each subsystem dependent on input regarding its own health status and that of all other subsystems. In a second step, the discrete model is generalized into a continuous model that captures system failure, as well as system repair, by a first order differential equation. Failure is approximated by a logistic decline and repair is approximated by a logistic rise in health. A small drop in health of a single subsystem spreads throughout the entire system and affects its overall health. Unless counteracted by measures of therapy or repair, any time-related loss in health of individual subsystems leads to a decline in health of the entire system. The delay in onset of therapy represents the most crucial factor to influence the overall cumulative decline in health. The model suggests that medical management needs to be expeditious to minimize the cumulative time-dependent toll of illness on the entire body.
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