预测新生儿败血症 30 天死亡率的实用预测模型。

Revista da Associacao Medica Brasileira (1992) Pub Date : 2024-08-16 eCollection Date: 2024-01-01 DOI:10.1590/1806-9282.20231561
Tengfei Qiao, Xiangwen Tu
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摘要

目的:新生儿败血症是一种严重的疾病,需要及时和立即的医疗救助。迄今为止,还没有特定的预后生物标志物或模型来可靠地预测新生儿败血症的结果。本研究的目的是根据现成的实验室数据建立一个预测模型,以评估新生儿败血症的 30 天死亡率:方法:在2019年1月至2022年12月期间招募患有败血症的新生儿。从病历中回顾性获取入院信息。利用单变量或多变量分析确定独立的风险因素。绘制接收者操作特征曲线来检验预测模型的性能:共招募了 195 名患者。两组患者的血红蛋白水平和凝血酶原时间差异很大。多变量分析证实,血红蛋白>133 克/升(危险比:0.351,P=0.042)和凝血酶原时间>16.6 秒(危险比:4.140,P=0.005)是 30 天死亡率的独立风险指标。基于这些结果,我们建立了一个曲线下面积(0.756)最大的预测模型:结论:我们建立的预测模型可以客观、准确地预测个体化的 30 天死亡率风险。结论:我们建立的预测模型能客观、准确地预测个体化的 30 天死亡风险,该预测模型应能帮助临床医生改善个体化治疗、做出临床决策并指导后续管理策略。
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A practical predictive model to predict 30-day mortality in neonatal sepsis.

Objective: Neonatal sepsis is a serious disease that needs timely and immediate medical attention. So far, there is no specific prognostic biomarkers or model for dependable predict outcomes in neonatal sepsis. The aim of this study was to establish a predictive model based on readily available laboratory data to assess 30-day mortality in neonatal sepsis.

Methods: Neonates with sepsis were recruited between January 2019 and December 2022. The admission information was obtained from the medical record retrospectively. Univariate or multivariate analysis was utilized to identify independent risk factors. The receiver operating characteristic curve was drawn to check the performance of the predictive model.

Results: A total of 195 patients were recruited. There was a big difference between the two groups in the levels of hemoglobin and prothrombin time. Multivariate analysis confirmed that hemoglobin>133 g/L (hazard ratio: 0.351, p=0.042) and prothrombin time >16.6 s (hazard ratio: 4.140, p=0.005) were independent risk markers of 30-day mortality. Based on these results, a predictive model with the highest area under the curve (0.756) was built.

Conclusion: We established a predictive model that can objectively and accurately predict individualized risk of 30-day mortality. The predictive model should help clinicians to improve individual treatment, make clinical decisions, and guide follow-up management strategies.

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