Prediction model for quality of life in sepsis survivors one year after discharge.

IF 3.2 3区 医学 Q1 EMERGENCY MEDICINE
Yi Yao, Wenjin Li, Dejiang Hong, Ze Chen, Kai Peng, Guangju Zhao
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Abstract

BACKGROUND: Sepsis survivors experience poor long-term quality of life post-discharge. The aim of this study was to analyze the factors that impact the long-term quality of life of sepsis survivors and develop a clinical prediction model. METHODS: A total of 442 sepsis patients from the Emergency Intensive Care Unit of a tertiary hospital in Wenzhou were included. These patients were assigned to the training set or the validation set at a ratio of 7:3. The European Quality of Life 5 Dimensions 5 Level Version (EQ-5D-5L) questionnaire was used to evaluate the quality of life in sepsis survivors one year after discharge. Multivariate logistic regression analysis was used to identify predictors, which were then used to develop the prediction model and subsequently derive a scoring system. The model's effectiveness was assessed using an area under the receiver operating characteristic curve, calibration curves, and clinical decision analysis. RESULTS: Of the 442 patients included, 70 died one year after discharge, and 372 completed the questionnaire. A total of 46.6% of sepsis survivors have poor quality of life one year after discharge in the training set. Multivariate logistic regression revealed that age, platelet, serum albumin, serum urea, and C-reactive protein were independent risk factors for poor quality of life in sepsis survivors. The area under the curve of the scoring system was 0.777 (95% CI: 0.726-0.828). The calibration curves showed that it was well calibrated. Decision curve analysis indicated that the scoring system provided good clinical usefulness. The internal validation also demonstrated its effectiveness. CONCLUSION: The prediction model incorporating five risk factors may predict quality of life one year after discharge in sepsis survivors, which provides a measure to develop post-discharge rehabilitation and follow-up plans for this patient population.

脓毒症患者出院后一年生活质量的预测模型。
背景:脓毒症患者出院后的长期生活质量较差。本研究旨在分析影响脓毒症幸存者长期生活质量的因素,并建立临床预测模型。方法:选取温州市某三级医院急诊重症监护室的442例脓毒症患者作为研究对象。将这些患者按7:3的比例分配到训练集或验证集。采用欧洲生活质量5维度5水平版本(EQ-5D-5L)问卷评估脓毒症幸存者出院后1年的生活质量。多变量逻辑回归分析用于确定预测因子,然后用于开发预测模型,随后导出评分系统。使用受试者工作特征曲线下面积、校准曲线和临床决策分析来评估模型的有效性。结果:纳入的442例患者中,70例出院后1年死亡,372例完成了问卷调查。在训练集中,共有46.6%的脓毒症幸存者在出院一年后生活质量较差。多因素logistic回归显示,年龄、血小板、血清白蛋白、血清尿素和c反应蛋白是脓毒症幸存者生活质量差的独立危险因素。评分系统曲线下面积为0.777 (95% CI: 0.726-0.828)。标定曲线表明,标定效果良好。决策曲线分析表明,该评分系统具有较好的临床应用价值。内部验证也证明了该方法的有效性。结论:结合5种危险因素的预测模型可以预测脓毒症患者出院后1年的生活质量,为该患者群体制定出院后康复及随访计划提供了依据。
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
CiteScore
2.50
自引率
28.60%
发文量
671
期刊介绍: The journal will cover technical, clinical and bioengineering studies related to multidisciplinary specialties of emergency medicine, such as cardiopulmonary resuscitation, acute injury, out-of-hospital emergency medical service, intensive care, injury and disease prevention, disaster management, healthy policy and ethics, toxicology, and sudden illness, including cardiology, internal medicine, anesthesiology, orthopedics, and trauma care, and more. The journal also features basic science, special reports, case reports, board review questions, and more. Editorials and communications to the editor explore controversial issues and encourage further discussion by physicians dealing with emergency medicine.
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