Wilson评分预测困难气道准确性的Meta分析  

Diagnostic Accuracy of Wilson Score for Predicating Difficult Intubation:A Meta-Analysis

作　　者：李晓强[1] 林静[1] 刘俐[2] 闵婕[3] 

机构地区：[1]四川大学华西医院麻醉科,成都610041 [2]四川大学华西医院疼痛病房,成都610041 [3]四川大学华西医院中西医结合科,成都610041

出　　处：《中国循证医学杂志》2013年第5期574-579,共6页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价Wilson评分预测困难气道的准确性。方法计算机检索PubMed、EMbase、CNKI、WanFang Data和VIP数据库,纳入Wilson评分预测困难气道准确性的文献,检索时间截至2013年1月。由两位研究者独立进行文献筛选、资料提取,并采用QUADAS条目评价纳入研究的方法学质量后,使用Meta-Disc 1.4软件通过随机效应模型计算合并敏感度、特异度、阳性似然比、阴性似然比、诊断比值比及其95%CI,绘制综合受试者工作特征曲线(SROC),以综合探讨Wilson评分预测困难气道的总体诊断准确性。结果共纳入9个研究,包括6 506例研究对象。Meta分析结果显示:Wilson评分预测困难气道的合并敏感度为0.57[95%CI(0.53,0.62)],特异度为0.89[95%CI(0.88,0.90),阳性似然比为6.11[95%CI(4.63,8.07)],阴性似然比为0.52[95%CI(0.41,0.66)],诊断比值比为12.76[95%CI(8.60,18.93)],SROC曲线下面积为0.84。结论 Wilson评分对于困难气道具有一定的预测价值,但应用中还需要参考其他临床指标。Objective To evaluate the diagnostic accuracy of Wilson score for predicating difficult intubation. Methods Such databases as PubMed, EMbase, CNKI, WanFang Data and VIP were searched to collect the studies about Wilson score for predicating difficult intubation published from inception to January 2013. Two reviewers independently screened the studies, extracted the data, and assessed the methodological quality by QUADAS. The analysis was conducted by using Meta-Disc 1.4 software, and the random effect model was chosen to calculate the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and the 95%CI. The summary receiver operating characteristic （SROC） curve was drawn and the area under the curve （AUC） was calculated in order to comprehensively assess the total diagnostic accuracy of Wilson score for predicating difficult intubation. Results A total of 9 studies in- volving 6 506 subjects were included. The results of meta-analysis showed that： the pooled sensitivity was 0.57 （95%CI 0.53 to 0.62）, specificity was 0.89 （95%CI 0.88 to 0.90）, positive likelihood ratio was 6.11 （95%CI 4.63 to 8.07）, negative likeli- hood ratio was 0.52 （95%CI 0.41 to 0.66）, diagnostic odds ratio was 12.76 （95%CI 8.60 to 18.93）, and the AUC of SROC was 0.84. Conclusion Wilson score plays a role in predicating difficult intubation, while some other clinical indicators also need to be taken into consideration in its application.

关 键 词：Wilson评分 困难气道 预测 META分析 诊断性试验 

分 类 号：R614[医药卫生—麻醉学]