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用于预测接受血液透析治疗的急性肾损伤犬预后的临床评分系统的验证

Validation of a Clinical Scoring System for Outcome Prediction in Dogs with Acute Kidney Injury Managed by Hemodialysis.

作者信息

Segev G, Langston C, Takada K, Kass P H, Cowgill L D

机构信息

Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Israel.

The Ohio State University Veterinary Medical Center, School of Veterinary Medicine, University of California, Davis, CA.

出版信息

J Vet Intern Med. 2016 May;30(3):803-7. doi: 10.1111/jvim.13930. Epub 2016 Mar 20.

Abstract

BACKGROUND

A scoring system for outcome prediction in dogs with acute kidney injury (AKI) recently has been developed but has not been validated.

HYPOTHESIS

The scoring system previously developed for outcome prediction will accurately predict outcome in a validation cohort of dogs with AKI managed with hemodialysis.

ANIMALS

One hundred fifteen client-owned dogs with AKI.

METHODS

Medical records of dogs with AKI treated by hemodialysis between 2011 and 2015 were reviewed. Dogs were included only if all variables required to calculate the final predictive score were available, and the 30-day outcome was known. A predictive score for 3 models was calculated for each dog. Logistic regression was used to evaluate the association of the final predictive score with each model's outcome. Receiver operating curve (ROC) analyses were performed to determine sensitivity and specificity for each model based on previously established cut-off values.

RESULTS

Higher scores for each model were associated with decreased survival probability (P < .001). Based on previously established cut-off values, 3 models (models A, B, C) were associated with sensitivities/specificities of 73/75%, 71/80%, and 75/86%, respectively, and correctly classified 74-80% of the dogs.

CONCLUSIONS AND CLINICAL RELEVANCE

All models were simple to apply and allowed outcome prediction that closely corresponded with actual outcome in an independent cohort. As expected, accuracies were slightly lower compared with those from the previously reported cohort used initially to develop the models.

摘要

背景

最近已开发出一种用于预测急性肾损伤(AKI)犬预后的评分系统,但尚未得到验证。

假设

先前开发的用于预后预测的评分系统将准确预测接受血液透析治疗的AKI犬验证队列的预后。

动物

115只客户拥有的AKI犬。

方法

回顾了2011年至2015年间接受血液透析治疗的AKI犬的病历。仅当计算最终预测分数所需的所有变量都可用且已知30天预后时才纳入犬只。为每只犬计算3种模型的预测分数。使用逻辑回归评估最终预测分数与每种模型预后的关联。基于先前确定的临界值进行受试者工作特征曲线(ROC)分析,以确定每种模型的敏感性和特异性。

结果

每种模型得分越高,生存概率越低(P <.001)。基于先前确定的临界值,3种模型(模型A、B、C)的敏感性/特异性分别为73/75%、71/80%和75/86%,并正确分类了74 - 80%的犬只。

结论及临床意义

所有模型应用简单,能够在独立队列中进行与实际预后密切相符的预后预测。正如预期的那样,与最初用于开发模型的先前报道队列相比,准确性略低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75ba/4913579/8f4ab2b3a086/JVIM-30-803-g001.jpg

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