老年髋部骨折患者肺部感染风险预测模型的系统评价  

Predictive models for lung infections in elderly patient with hip fracture:a systematic review

作　　者：张婉静 杨柳 张大学 黄秋玉 车金燕 章宁 阳世伟[3] Zhang Wanjing;Yang Liu;Zhang Daxue;Huang Qiuyu;Che Jinyan;Zhang Ning;Yang Shiwei(School of Nursing,Guangxi University of Chinese Medicine,Nanning 530200,Guangxi Zhuang Autonomous Region,China;Department of Osteoarthritic Bone Oncology,The Second People’s Hospital of Shenzhen,Shenzhen 518000,Guangdong Province,China;Teaching Affairs Office,The Second People’s Hospital of Shenzhen,Shenzhen 518000,Guangdong Province,China;School of Nursing,Anhui Medical University,Hefei 230000,Anhui Province,China.)

机构地区：[1]广西中医药大学护理学院,广西南宁530200 [2]深圳市第二人民医院骨关节骨肿瘤科,广东深圳518000 [3]深圳市第二人民医院教学办公室,广东深圳518000 [4]安徽医科大学护理学院,安徽合肥230000

出　　处：《现代临床护理》2025年第2期83-90,共8页Modern Clinical Nursing

基　　金：医院院内临床研究项目,项目编号为20213357012;深圳市科技计划项目,项目编号为JCYJ20230807115118037。

摘　　要：目的系统评价关于老年髋部骨折患者肺部感染风险预测模型,以期为临床医护人员选择或开发适合的风险预测模型提供参考。方法采用计算机系统检索CNKI,万方,维普,SinoMed,PubMed,Web of Science,Cochrane Library,Embase,CINAHL中关于老年髋部骨折患者肺部感染风险预测模型的文献。检索时限为建库至2024年1月31日。从选定的文献中提取相关数据,并使用预测模型偏倚风险评估工具评价纳入文献的偏倚风险和适用性。结果共检索到1035项研究,经过筛选后最终纳入7项研究,涉及13个预测模型,样本量在305~2669例之间,肺部感染率为5.40%~20.02%。年龄,性别,慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD),低蛋白血症,美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级,白细胞计数是重复报告的预测因子。构建的13个模型报告的受试者工作特征曲线下面积(area under the curve,AUC)为0.667~0.996。7项研究中有5项总体适用性较好,但所有研究都存在高偏倚风险。结论老年髋部骨折患者肺部感染预测模型尚处于发展阶段,尽管纳入研究的预测模型具有一定的预测性能,但是这些预测模型仍存在不足,所有研究都被发现具有较高的偏倚风险。Objective To systematically evaluate the published models in prediction of the risk of lung infections in elderly patients with hip fracture so as to provide a guidance for medical workers in selection or development of suitable risk prediction models.Methods Relevant studies were searched from databases including CNKI,Wanfang Data,VIP,SinoMed,PubMed,Web of Science,Cochrane Library,Embase and CINAHL,from the inception to 31st January,2024.Data were extracted from the selected literature and a bias assessment tool of risk predictive model was used to evaluate the risk of bias and applicability of the included literature.Results A total of 1,035 articles were retrieved,of which seven studies involving 13 predictive models were finally included after screening.The sample sizes ranged from 305 to 2,669 cases and lung infection rates ranged from 5.40%to 20.02%.The repeatedly reported predictors included age,gender,chronic obstructive pulmonary disease,hypoproteinaemia,American Society of Anesthesiologists(ASA)Physical Status Classification and white blood cell count.In the 13 models constructed,the reported area under the curve(AUC)of subjects’job characteristics ranged from 0.667 to 0.996.Five out of seven studies had good overall applicability,but all with high risk of bias.Conclusion The predictive models for lung infections in elderly patients with hip fracture are still in the stage of development.Although the predictive models show some predictive performance,however they are still deficient,and all studies have been found with a high risk in bias.

关 键 词：老年 髋部骨折 肺部感染 预测模型 系统评价 

分 类 号：R473.6[医药卫生—护理学]