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验证和比较两种糖尿病患者 30 天再入院预测模型。

VALIDATION AND COMPARISON OF TWO 30-DAY RE-ADMISSION PREDICTION MODELS IN PATIENTS WITH DIABETES.

出版信息

Endocr Pract. 2019 Nov;25(11):1151-1157. doi: 10.4158/EP-2019-0125. Epub 2019 Aug 15.

Abstract

The objective was to evaluate the 30-day re-admission predictive performance of the HOSPITAL score and Diabetes Early Re-admission Risk Indicator (DERRI) in hospitalized diabetes patients. This was a case-control study in an academic, tertiary center in the United States. Adult hospitalized diabetes patients were randomly identified between January 1, 2014, and September 30, 2017. Patients were categorized into two groups: () re-admitted within 30 days, and () not re-admitted within 30 days. Predictive performance of the HOSPITAL and DERRI scores was evaluated by calculating receiver operating characteristics curves (c-statistic), Hosmer-Lemeshow goodness-of-fit tests, and Brier scores. A total of 200 patients were included (100 re-admitted, 100 non-re-admitted). The HOSPITAL score had a c-statistic of 0.731 (95% confidence interval [CI], 0.661 to 0.800), Hosmer-Lemeshow test = .211, and Brier score 0.212. The DERRI score had a c-statistic of 0.796 (95% CI, 0.734 to 0.857), Hosmer-Lemeshow test = .114, and Brier score 0.212. The difference in receiver operating characteristic curves was not statistically significant between the two scores but showed a higher c-statistic with the DERRI score ( = .055). Both HOSPITAL and DERRI scores showed good predictive performance in 30-day re-admission of adult hospitalized diabetes patients. There was no significant difference in discrimination and calibration between the scores. = confidence interval; = Diabetes Early Re-admission Risk Indicator; = interquartile range.

摘要

目的在于评估 HOSPITAL 评分和糖尿病早期再入院风险指标(DERRI)在住院糖尿病患者中 30 天再入院的预测性能。这是在美国一家学术性三级中心进行的病例对照研究。2014 年 1 月 1 日至 2017 年 9 月 30 日期间,随机确定住院的糖尿病患者。将患者分为两组:()在 30 天内再入院,()在 30 天内未再入院。通过计算接收者操作特征曲线(c 统计量)、Hosmer-Lemeshow 拟合优度检验和 Brier 评分来评估 HOSPITAL 和 DERRI 评分的预测性能。共纳入 200 例患者(100 例再入院,100 例未再入院)。HOSPITAL 评分的 c 统计量为 0.731(95%置信区间 [CI],0.661 至 0.800),Hosmer-Lemeshow 检验 =.211,Brier 评分 0.212。DERRI 评分的 c 统计量为 0.796(95%CI,0.734 至 0.857),Hosmer-Lemeshow 检验 =.114,Brier 评分 0.212。两个评分之间的接收者操作特征曲线差异无统计学意义,但 DERRI 评分的 c 统计量较高( =.055)。HOSPITAL 和 DERRI 评分均能较好地预测成年住院糖尿病患者的 30 天再入院。评分之间的区分度和校准度无显著差异。95%CI = 置信区间;DERRI = 糖尿病早期再入院风险指标;IQR = 四分位距。

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