以患者为中心的变量与非计划性 ICU 入院的单变量相关性：系统综述。
Patient centred variables with univariate associations with unplanned ICU admission: a systematic review.
机构信息
Kadoorie Centre for Critical Care Research and Education, Nuffield Department of Clinical Neurosciences, University of Oxford, Level 3, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.
Department of Critical Care, University College London Hospitals Foundation Trust, Maple Link Bridge, University College Hospital, 235 Euston Road, London, NW1 2BU, UK.
出版信息
BMC Med Inform Decis Mak. 2019 May 15;19(1):98. doi: 10.1186/s12911-019-0820-1.
BACKGROUND
Multiple predictive scores using Electronic Patient Record data have been developed for hospitalised patients at risk of clinical deterioration. Methods used to select patient centred variables for inclusion in these scores varies. We performed a systematic review to describe univariate associations with unplanned Intensive Care Unit (ICU) admission with the aim of assisting model development for future scores that predict clinical deterioration.
METHODS
Data sources were MEDLINE, EMBASE, CINAHL, CENTRAL and the Cochrane Database of Systematic Reviews. Included studies were published since 2000 describing an association between patient centred variables and unplanned ICU admission determined using univariate analysis. Two authors independently screened titles, abstracts and full texts against inclusion and exclusion criteria. DistillerSR (Evidence Partners, Canada, Ottawa, Ontario) software was used to manage the data and identify duplicate search results. All screening and data extraction forms were implemented within DistillerSR. Study quality was assessed using an adapted version of the Newcastle-Ottawa Scale. Variables were analysed for strength of association with unplanned ICU admission.
RESULTS
The database search yielded 1520 unique studies; 1462 were removed after title and abstract review; 57 underwent full text screening; 16 studies were included. One hundred and eighty nine variables with an evaluated univariate association with unplanned ICU admission were described.
DISCUSSION
Being male, increasing age, a history of congestive cardiac failure or diabetes, a diagnosis of hepatic disease or having abnormal vital signs were all strongly associated with ICU admission.
CONCLUSION
These findings will assist variable selection during the development of future models predicting unplanned ICU admission.
TRIAL REGISTRATION
This study is a component of a larger body of work registered in the ISRCTN registry ( ISRCTN12518261 ).
背景
已经开发出了多种使用电子病历数据的预测评分，用于预测住院患者临床恶化的风险。用于选择纳入这些评分的以患者为中心的变量的方法各不相同。我们进行了一项系统评价，描述与计划外重症监护病房（ICU）入院相关的单变量关联，旨在协助开发用于预测临床恶化的未来评分模型。
方法
数据来源为 MEDLINE、EMBASE、CINAHL、CENTRAL 和 Cochrane 系统评价数据库。纳入的研究自 2000 年以来发表，描述了使用单变量分析确定的以患者为中心的变量与计划外 ICU 入院之间的关联。两名作者独立筛选标题、摘要和全文，以确定纳入和排除标准。使用 Evidence Partners（加拿大安大略省渥太华）的 DistillerSR 软件管理数据并识别重复的搜索结果。所有筛选和数据提取表格都在 DistillerSR 中实现。使用改良的 Newcastle-Ottawa 量表评估研究质量。分析变量与计划外 ICU 入院的关联强度。
结果
数据库搜索产生了 1520 项独特的研究；标题和摘要审查后排除了 1462 项；57 项进行了全文筛选；纳入了 16 项研究。描述了 189 个具有评估的与计划外 ICU 入院单变量关联的变量。
讨论
男性、年龄增长、充血性心力衰竭或糖尿病史、肝脏疾病诊断或生命体征异常均与 ICU 入院密切相关。
结论
这些发现将有助于在开发预测计划外 ICU 入院的未来模型时选择变量。
试验注册
本研究是在 ISRCTN 注册中心（ISRCTN63634376）注册的更大规模研究的一部分。
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