[Prognostic model of a patient with sepsis readiness to early mobilization with assistance].

Q4 Medicine

Voprosy kurortologii, fizioterapii, i lechebnoi fizicheskoi kultury Pub Date : 2025-01-01 DOI:10.17116/kurort202510202126

I A Ruslyakova, E Z Shamsutdinova, K I Shirokov, N E Ivanova

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引用次数: 0

Abstract

Management of the early rehabilitation (passive, assisted, active) risks will allow to minimize complications and increase safety of patients with sepsis.

Objective: To develop a prognostic model of patient with sepsis readiness to early mobilization with assistance.

Material and methods: A single-center retrospective cohort observational study with analysis of 780 electronic medical records of patients with sepsis from the «Intensive therapy of patients with severe community-acquired pneumonia» base of the North-Western State Medical University named after I. I. Mechnikov in the period from 2013 to 2022 was carried out. Statistical analysis by binary logistic regression method and ROC-analysis were performed using Jamovi 2.3.21 and IBM SPSS Statistics 26 softwares package.

Results: The study includes the data of 519 patients with sepsis. Patients are divided into 2 study groups according to the score on the Intensive Care Unit Mobility Scale (IMS): IMS 0/1 (281 patients) and IMS ≥2 (238 patients). The predictors of IMS ≥2 for patients with sepsis have been determined: score on the APACHE II assessment scale of patient's state severity ≤20.0 (adjusted odds ratio (AOR) 6.38; 95% CI 3.01-13.5; p<0.001), score on the CCI Charlson comorbidity index ≤3.0 (AOR 3.84; 95% CI 1.72-8.58; p=0.001), score on the mNUTRIC critical state risk scale ≤5.0 (AOR 2.81; 95% CI 1.33-5.96; p=0.007), PO₂/FiO₂ index >119.0 mm Hg (AOR 104; 95% CI 29.59-365.6; p<0.001), albumin level >25.0 g/l (AOR 2.37; 95% CI 1.11-5.06; p=0.025). The prognostic model that considers 82.3% of factors determining the dispersion of IMS ≥2 probability has been developed. Area under ROC-curve amounted to 0.967±0.007 (95% CI 0.952-0.982). Sensitivity and specificity of IMS ≥2 prognostic model in patients with sepsis at 65% threshold were 92.0 and 92.6%, respectively, and accuracy - 92.3%.

Conclusion: The prognostic model of patient with sepsis readiness to early mobilization with assistance has been developed based on IMS ≥2 independent predictors. This model allows to use individual approach to early mobilization with assistance and identify patients who are ready to increase physical exertion without worsening clinical condition.

查看原文本刊更多论文

[脓毒症患者在辅助下早期动员的预后模型]。

对早期康复（被动、辅助、主动）风险的管理将使并发症最小化，并提高败血症患者的安全性。目的：建立脓毒症患者在辅助下早期动员的预后模型。材料与方法：采用单中心回顾性队列观察研究，对2013 - 2022年美国西北国立医科大学I. I. Mechnikov“重症社区获得性肺炎患者强化治疗”基地780例败血症患者电子病历进行分析。采用Jamovi 2.3.21和IBM SPSS Statistics 26软件包进行统计学分析，采用二元逻辑回归法和roc分析。结果：纳入519例脓毒症患者资料。根据重症监护病房活动量表（IMS）得分将患者分为IMS 0/1（281例）和IMS≥2（238例）2个研究组。已经确定了脓毒症患者IMS≥2的预测因素：患者状态严重程度的APACHE II评估量表得分≤20.0(调整优势比（AOR） 6.38；95% ci 3.01-13.5；pp=0.001)， mNUTRIC临界状态风险量表评分≤5.0 (AOR 2.81；95% ci 1.33-5.96；p=0.007)， PO2/FiO2指数>119.0 mm Hg (AOR 104；95% ci 29.59-365.6；p25.0 g/l (AOR 2.37；95% ci 1.11-5.06；p = 0.025)。建立了考虑82.3%决定IMS≥2概率离散度因素的预后模型。roc曲线下面积为0.967±0.007 （95% CI 0.952 ~ 0.982）。IMS≥2预后模型对脓毒症患者65%阈值的敏感性和特异性分别为92.0和92.6%，准确性为- 92.3%。结论：基于IMS≥2个独立预测因子，建立了脓毒症患者早期辅助活动准备度的预后模型。这个模型允许使用个人的方法来帮助早期动员和识别患者谁准备增加体力消耗而不恶化的临床状况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Voprosy kurortologii, fizioterapii, i lechebnoi fizicheskoi kultury Medicine-Medicine (all)

CiteScore

0.60

自引率

0.00%

发文量

期刊介绍： The journal deals with the study of the mechanism of a physiological and therapeutic effect of physical and health resort factors, methods and results of their employment, as well as with theoretical and practical problems involved in the use of exercise therapy in combined treatment of different diseases. The results of research and experience of using physical and health resort methods in medical practice and organization of physiotherapeutic and sanatorial and health resort service, book reviews on physiotherapy, health resort science and exercise therapy are published. Scientific life of allied specialities, proceedings of congresses, conferences, symposia (including foreign), the activity of republican and local societies, etc., are covered.