生存方法，包括那些使用竞争风险分析的方法，不适用于重症监护病房结局研究。
Survival methods, including those using competing risk analysis, are not appropriate for intensive care unit outcome studies.
作者信息
Schoenfeld David
机构信息
Harvard Medical School, Massachusetts General Hospital Biostatistics Center, Staniford Street, Boston, MA 02114, USA.
出版信息
Crit Care. 2006 Feb;10(1):103. doi: 10.1186/cc3949.
Abstract
The preferred analysis for studies of mortality among patients treated in an intensive care unit should compare the proportions of patients who died during hospitalization. Studies that look for prognostic covariates should use logistic regression. Survival methods, such as the proportional hazards model, or methods based on competing risk analysis are not appropriate because prolonged survival among patients that die during their hospitalization does not benefit the patient and, therefore, should not be measured in the statistical analysis.
摘要
对重症监护病房接受治疗的患者进行死亡率研究时，首选的分析方法应是比较住院期间死亡患者的比例。寻找预后协变量的研究应使用逻辑回归。生存方法，如比例风险模型或基于竞争风险分析的方法并不适用，因为在住院期间死亡的患者延长生存时间对患者并无益处，因此在统计分析中不应进行衡量。
相似文献
1
Survival methods, including those using competing risk analysis, are not appropriate for intensive care unit outcome studies.生存方法，包括那些使用竞争风险分析的方法，不适用于重症监护病房结局研究。
Crit Care. 2006 Feb;10(1):103. doi: 10.1186/cc3949.
2
Evaluating mortality in intensive care units: contribution of competing risks analyses.评估重症监护病房的死亡率：竞争风险分析的作用。
Crit Care. 2006 Feb;10(1):R5. doi: 10.1186/cc3921.
3
Intensive care unit outcomes among patients with lung cancer in the surveillance, epidemiology, and end results-medicare registry.监测、流行病学和最终结果-医疗保险登记处肺癌患者的重症监护病房结局。
J Clin Oncol. 2012 May 10;30(14):1686-91. doi: 10.1200/JCO.2011.40.0846. Epub 2012 Apr 2.
4
Survival rates following medical intensive care unit admission from 2003 to 2013: An observational study based on a representative population-based sample cohort of Korean patients.2003年至2013年入住医学重症监护病房后的生存率：一项基于韩国患者具有代表性的基于人群样本队列的观察性研究。
Medicine (Baltimore). 2019 Sep;98(37):e17090. doi: 10.1097/MD.0000000000017090.
5
Predictors of Survival in Patients with Advanced Gastrointestinal Malignancies Admitted to the Intensive Care Unit.重症监护病房收治的晚期胃肠道恶性肿瘤患者的生存预测因素。
Oncologist. 2019 Apr;24(4):483-490. doi: 10.1634/theoncologist.2018-0328. Epub 2018 Dec 5.
6
Outcome in patients with long-term treatment in a surgical intensive care unit.长期在外科重症监护病房治疗的患者的结局。
Langenbecks Arch Surg. 2012 Aug;397(6):995-9. doi: 10.1007/s00423-012-0966-0. Epub 2012 Jun 15.
7
Outcomes of octogenarians discharged from the hospital after prolonged intensive care unit length of stay after cardiac surgery.心脏手术后在重症监护病房长时间住院后出院的 80 岁以上老人的结局。
J Thorac Cardiovasc Surg. 2017 Nov;154(5):1668-1678.e2. doi: 10.1016/j.jtcvs.2017.04.083. Epub 2017 Jul 6.
8
Pharmacologic Treatment of Intensive Care Unit Delirium and the Impact on Duration of Delirium, Length of Intensive Care Unit Stay, Length of Hospitalization, and 28-Day Mortality.重症监护病房谵妄的药物治疗及对谵妄持续时间、重症监护病房住院时间、住院时间和 28 天死亡率的影响。
Mayo Clin Proc. 2018 Dec;93(12):1739-1748. doi: 10.1016/j.mayocp.2018.06.022. Epub 2018 Oct 3.
9
Clinician predictions of intensive care unit mortality.临床医生对重症监护病房死亡率的预测。
Crit Care Med. 2004 May;32(5):1149-54. doi: 10.1097/01.ccm.0000126402.51524.52.
10
Benefit of antiretroviral therapy on survival of human immunodeficiency virus-infected patients admitted to an intensive care unit.抗逆转录病毒疗法对入住重症监护病房的人类免疫缺陷病毒感染患者生存的益处。
Crit Care Med. 2009 May;37(5):1605-11. doi: 10.1097/CCM.0b013e31819da8c7.
引用本文的文献
1
Two-part model for ventilator-free days in a cluster randomized cross-over clinical trial.群组随机交叉临床试验中无呼吸机天数的两部分模型
BMC Med Res Methodol. 2025 Aug 26;25(1):200. doi: 10.1186/s12874-025-02653-8.
2
Socially integrated female chimpanzees have lower offspring mortality.社会融合度高的雌性黑猩猩后代死亡率较低。
iScience. 2025 Jun 9;28(7):112863. doi: 10.1016/j.isci.2025.112863. eCollection 2025 Jul 18.
3
Sex as a prognostic factor for mortality in adults with acute symptomatic pulmonary embolism.性别作为急性症状性肺栓塞成年患者死亡率的一个预后因素。
Cochrane Database Syst Rev. 2025 Mar 20;3(3):CD013835. doi: 10.1002/14651858.CD013835.pub2.
4
Eliminating Bias in Survival Estimation: Statistical Bias Mitigation Is the First Step Forward.消除生存估计中的偏差：减轻统计偏差是向前迈出的第一步。
Crit Care Med. 2024 Mar 1;52(3):506-509. doi: 10.1097/CCM.0000000000006110. Epub 2024 Feb 21.
5
Validation of a pre-established triage protocol for critically ill patients in a COVID-19 outbreak under resource scarcity: A retrospective multicenter cohort study.在资源匮乏的情况下，对 COVID-19 疫情中危重症患者进行预先制定的分诊方案的验证：一项回顾性多中心队列研究。
PLoS One. 2023 May 11;18(5):e0285690. doi: 10.1371/journal.pone.0285690. eCollection 2023.
6
Causal Bayesian machine learning to assess treatment effect heterogeneity by dexamethasone dose for patients with COVID-19 and severe hypoxemia.基于因果贝叶斯机器学习评估 COVID-19 伴严重低氧血症患者地塞米松剂量治疗效果的异质性。
Sci Rep. 2023 Apr 21;13(1):6570. doi: 10.1038/s41598-023-33425-3.
7
Re-analysis of ventilator-free days (VFD) in acute respiratory distress syndrome (ARDS) studies.急性呼吸窘迫综合征（ARDS）研究中无通气天数（VFD）的再分析。
Trials. 2023 Mar 13;24(1):183. doi: 10.1186/s13063-023-07190-7.
8
Data quality considerations for evaluating COVID-19 treatments using real world data: learnings from the National COVID Cohort Collaborative (N3C).利用真实世界数据评估 COVID-19 治疗方法的数据质量考量因素：来自国家 COVID 队列协作组织（N3C）的经验教训。
BMC Med Res Methodol. 2023 Feb 17;23(1):46. doi: 10.1186/s12874-023-01839-2.
9
Association of Positive End-Expiratory Pressure and Lung Recruitment Selection Strategies with Mortality in Acute Respiratory Distress Syndrome: A Systematic Review and Network Meta-analysis.呼气末正压和肺复张选择策略与急性呼吸窘迫综合征死亡率的关联：系统评价和网络荟萃分析。
Am J Respir Crit Care Med. 2022 Jun 1;205(11):1300-1310. doi: 10.1164/rccm.202108-1972OC.
10
Impact of Comorbidities on Beneficial Effect of Lactated Ringers vs. Saline in Sepsis Patients.合并症对脓毒症患者使用乳酸林格液与生理盐水的有益效果的影响。
Front Med (Lausanne). 2021 Dec 13;8:758902. doi: 10.3389/fmed.2021.758902. eCollection 2021.
本文引用的文献
1
Evaluating mortality in intensive care units: contribution of competing risks analyses.评估重症监护病房的死亡率：竞争风险分析的作用。
Crit Care. 2006 Feb;10(1):R5. doi: 10.1186/cc3921.
2
Randomized, placebo-controlled trial of lisofylline for early treatment of acute lung injury and acute respiratory distress syndrome.利索茶碱用于急性肺损伤和急性呼吸窘迫综合征早期治疗的随机、安慰剂对照试验。
Crit Care Med. 2002 Jan;30(1):1-6. doi: 10.1097/00003246-200201000-00001.
3
Nonparametric estimation in a cure model with random cure times.具有随机治愈时间的治愈模型中的非参数估计。
Biometrics. 2001 Mar;57(1):282-6. doi: 10.1111/j.0006-341x.2001.00282.x.
4
Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome.保护性通气策略对急性呼吸窘迫综合征死亡率的影响。
N Engl J Med. 1998 Feb 5;338(6):347-54. doi: 10.1056/NEJM199802053380602.
5
Analysing survival in the presence of an auxiliary variable.在存在辅助变量的情况下分析生存情况。
Stat Med. 1994 Sep 15;13(17):1747-54. doi: 10.1002/sim.4780131706.
6
Properties of proportional-hazards score tests under misspecified regression models.错误设定回归模型下比例风险评分检验的性质。
Biometrics. 1984 Dec;40(4):1037-48.
Zotero 插件