老年髋部骨折患者术后肺炎风险预测模型的系统评价  

Systematic Review of Risk Prediction Models for Postoperative Pneumonia in Elderly Patients with Hip Fracture

作　　者：田海萍 乔婉婉 温贤秀[2] TIAN Haiping;QIAO Wanwan;WEN Xianxiu(School of Nursing,Chengdu University of Traditional Chinese Medicine,Chengdu 610075,Sichuan,China;Department of Nursing,Sichuan Academy of Medical Sciences·Sichuan Provincial People's Hospital/Affiliated Hospital of University of Electronic Science and Technology,Chengdu 610072,Sichuan,China)

机构地区：[1]成都中医药大学护理学院,四川成都610075 [2]四川省医学科学院·四川省人民医院/电子科技大学附属医院护理部,四川成都610072

出　　处：《医学信息》2024年第23期9-14,共6页Journal of Medical Information

基　　金：四川省卫计委适宜技术推广项目(编号:19SYJS39)。

摘　　要：目的系统评价老年髋部骨折患者术后肺炎风险预测模型。方法通过计算机检索CNKI、WanFang Data、VIP、CBM、Web of science、PubMed、EMbase、CINAHL数据库中有关老年髋部骨折患者术后肺炎风险预测模型的相关研究,检索时限为建库至2024年8月。由2名研究者独立筛选文献和提取数据,采用PROBAST评估工具对纳入文献质量进行评价,使用R4.4.1软件对模型的AUC值进行Meta分析。结果共纳入14项研究,共包含24个预测模型,其中13个模型曲线下面积在0.653~0.998,1个模型C-index为0.84,整体研究适用性一般,偏倚风险较高。Meta分析显示,10个经验证模型的合并AUC值为0.79(95%CI:0.75~0.83),区分度较好。常见的肺炎预测因子为年龄、血清白蛋白、COPD、ASA分级、骨折至手术时间等。结论老年髋部患者术后肺炎风险预测模型的整体预测性能较好,但模型的偏倚风险较高,临床适用性有待进一步验证。Objective To systematically evaluate the risk prediction model of postoperative pneumonia in elderly patients with hip fracture.Methods CNKI,WanFang Data,VIP,CBM,Web of science,PubMed,Embase and CINAHL databases were searched by computer for relevant studies on the risk prediction model of postoperative pneumonia in elderly patients with hip fracture from inception to August 2024.Two researchers independently screened the literature and extracted the data.The PROBAST evaluation tool was used to evaluate the quality of the included literature.R 4.4.1 software was used for Meta-analysis of the AUC value of the model.Results A total of 14 studies were included,including 24 prediction models.The area under the ROC curve of 13 models was 0.653-0.998,and the C-index of one model was 0.84.The overall applicability of the study was general and the risk of bias was high.Meta-analysis showed that the combined AUC value of the 10 validated models was 0.79(95%CI:0.75-0.83),and the discrimination was good.The common predictors of pneumonia were age,serum albumin,COPD,ASA classification,fracture to operation time,etc.Conclusion The overall predictive performance of the risk prediction model for postoperative pneumonia in elderly hip patients is good,but the risk of bias of the model is high,and the clinical applicability needs to be further verified.

关 键 词：老年 髋部骨折 肺炎 预测模型 偏倚风险 

分 类 号：R563.1[医药卫生—呼吸系统]