心脏术后患者重返重症监护室预测模型的范围综述  

Risk prediction models for returning to intensive care unit after cardiac surgery:a scoping review

作　　者：朱铃丽 倪子珺 徐剑锋[2] 赵锐祎[1] Zhu Lingli;Ni Zijun;Xu Jianfeng;Zhao Ruiyi(Nursing Department,the Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China;Respiratory Therapy Department,the Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China)

机构地区：[1]浙江大学医学院附属第二医院护理部,杭州310009 [2]浙江大学医学院附属第二医院呼吸治疗科,杭州310009

出　　处：《中国心血管杂志》2023年第5期454-459,共6页Chinese Journal of Cardiovascular Medicine

基　　金：浙江省医药卫生科技计划项目(2022KY810)。

摘　　要：目的对心脏术后重返重症监护室(ICU)预测模型的研究进行范围综述,为今后预测模型的优化或开发提供参考。方法检索中国知网、万方数据服务平台、维普中文科技期刊数据库、中国生物医学文献数据库、Web of Science、PubMed、MEDLINE、Cochrane Library和EMBASE有关心脏术后重返ICU预测模型的研究,检索时限为建库至2023年3月3日。由2名研究者根据CHARMS清单独立筛选、提取数据并以PROBAST工具评估模型偏倚和适用性。结果共纳入6篇文献,涉及6个模型,包括5项开发研究、1项外部验证及更新研究。研究对象集中于冠状动脉旁路移植术和心脏瓣膜术。模型均采用logistic回归分析构建,涉及的预测因子主要包括年龄、慢性肺疾病、射血分数等。模型的受试者工作特征曲线下面积(AUC)为0.74~0.89,偏倚评价结果显示纳入模型多存在较高的偏移风险。结论现有心脏外科术后重返ICU预测模型均未完全满足模型质量和适用性的要求。规范模型的方法学细节和验证情况,如采用TRIPOD报告规范和CHARM清单等,可提高模型的质量和透明度。Objective A scoping review of research on predictive models for returning to intensive care unit(ICU)after cardiac surgery to provide reference for future optimization or development of predictive models.Methods Databases(CNKI,WanFang,VIP,CBM,Web of Science,PubMed,MEDLINE,Cochrane Library and EMBASE)were searched from the inception to March 3,2023.Two researchers independently screened and extracted data according to the CHARMS checklist and assessed model bias and applicability with the PROBAST tool.Results The review included 6 studies involving 6 prediction models,comprising 5 model of construction studies and one model of external validation and update study.The population focused on patients undergoing coronary artery bypass grafting and heart valve surgeries.The models were constructed using logistic regression analysis and incorporated predictive factors like age,chronic lung disease,and ejection fraction.The area under the receiver operating characteristic curve(AUC)for the models ranged from 0.74 to 0.89.Bias assessment results indicated that most of the included models exhibited a higher risk of bias.Conclusions None of the existing prediction models for returning to ICU after cardiac surgery fully meets the requirements of model quality and applicability.To standardize the methodological details and validation procedures,such as adopting the reporting guidelines of TRIPOD and considering the use of the CHARM checklist,could enhance the quality and transparency of the models.

关 键 词：心脏外科手术 重症监护病房 预测模型 范围综述 

分 类 号：R654.2[医药卫生—外科学]