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基于pSOFA评分的儿童脓毒症预后预测模型的建立与分析

Establishment and analysis of the prediction model for the prognosis of children with sepsis based on pSOFA score.

作者信息

Guo Fang, Qu Yi, Kang Lei, Xu Meixian, Ma Li, Li Wenhui, You Dianping

机构信息

Fang Guo Department of Infectious Diseases, Hebei Children's Hospital, Shijiazhuang 050000, Hebei, China.

Yi Qu Department of Scientific research, Hebei Children's Hospital, Shijiazhuang 050000, Hebei, China.

出版信息

Pak J Med Sci. 2025 Apr;41(4):1126-1131. doi: 10.12669/pjms.41.4.10001.

Abstract

OBJECTIVE

To investigate the prognostic risk factors of sepsis in children diagnosed based on the pediatric sequential organ failure assessment (pSOFA) scoring system, and to establish and evaluate related prediction model.

METHODS

This was a retrospective study. Two hundred and seventy three children with sepsis admitted to Hebei Children's Hospital from January 1, 2019 to December 31, 2022 were divided into survival group and mortality group according to the prognosis. Multivariate Logisitic regression was used to analyze the independent risk factors affecting the prognosis of septic children, and a predictive model was established to analyze the predictive value of the model on the prognosis of septic children.

RESULTS

The results of multivariate logistic regression analysis showed that systemic vascular resistance index (SVRI) <1143, febrile neutropenia (FN) and pSOFA score were independent risk factors for sepsis-related death in children. This equation of 5.140+2.069 × (SVRI<1143) + 1.718 × FN+0.290 × pSOFA score indicates that, the area under the ROC curve of the prediction model is greater than that of SVRI<1143, FN, and pSOFA score alone, and the sensitivity and specificity of the model were 81.5% and 84.5%, respectively.

CONCLUSION

The prediction model has a good clinical predictive value and has practical significance for the prognosis evaluation and treatment guidance.

摘要

目的

基于儿童序贯器官衰竭评估(pSOFA)评分系统,探讨儿童脓毒症的预后危险因素,并建立和评估相关预测模型。

方法

本研究为回顾性研究。选取2019年1月1日至2022年12月31日在河北省儿童医院住院的273例脓毒症患儿,根据预后情况分为生存组和死亡组。采用多因素Logisitic回归分析影响脓毒症患儿预后的独立危险因素,并建立预测模型,分析该模型对脓毒症患儿预后的预测价值。

结果

多因素Logistic回归分析结果显示,全身血管阻力指数(SVRI)<1143、发热性中性粒细胞减少症(FN)及pSOFA评分是儿童脓毒症相关死亡的独立危险因素。5.140+2.069×(SVRI<1143)+1.718×FN+0.290×pSOFA评分这一公式表明,预测模型的ROC曲线下面积大于单独的SVRI<1143、FN及pSOFA评分,模型的敏感度和特异度分别为81.5%和84.5%。

结论

该预测模型具有良好的临床预测价值,对预后评估及治疗指导具有实际意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4d7/12022587/f2408a087aa5/PJMS-41-1126-g001.jpg

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