自发性小脑出血机械通气患者拔管成功率预测模型的开发

IF 2.7 3区 医学 Q3 NEUROSCIENCES
Yao Jiang, Yue Yu, Jing Fan, Lei Zhang, Yang Ye, Ying-Hong Hu, Li-da Su
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引用次数: 0

摘要

自发性小脑出血(SCH)患者的拔管成功率很低,但目前还没有专门针对SCH患者拔管的指南。该研究纳入了68例接受机械通气超过24小时的SCH患者,其中39例(57.3%)成功拔管。多变量分析确定了与拔管成功显著相关的四个因素:患者年龄小于 66 岁、脑出血(ICH)评分小于 4 分、存在组织移位以及拔管时格拉斯哥昏迷量表(GCS)评分(不包括语言)高于 6 分。通过简化预测模型,我们得到了自发性小脑出血拔管成功率评分系统(SCHES-SCORE)。在该评分系统中,拔管时 GCS 评分(不包括语言)高于 6 分得 2 分,年龄低于 66 岁和 ICH 评分低于 4 分各得 1 分,而组织移位得负分。A 级评分(SCHES-SCORE = 3-4)与 92.9% 的拔管成功率相关。接收者操作特征曲线下的面积为 0.923(95% CI,0.863 至 0.983)。值得注意的是,成功拔管与缩短机械通气时间、重症监护室(ICU)住院时间和总住院时间有明显关系。总之,为评估SCH患者的拔管结果而开发的评分系统有可能提高成功拔管率和患者的整体预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Development of Extubation Success Prediction Model for Mechanically Ventilated Patients with Spontaneous Cerebellar Hemorrhage.

Development of Extubation Success Prediction Model for Mechanically Ventilated Patients with Spontaneous Cerebellar Hemorrhage.

Spontaneous cerebellar hemorrhage (SCH) patients have a low success rate in extubation, but there are currently no guidelines establishing specifically for SCH patients extubation. The study included 68 SCH patients who received mechanical ventilation for more than 24 h, with 39 cases (57.3%) resulting in successful extubation. The multivariate analysis identified four factors significantly associated with extubation success: patient age under 66 years, an Intracerebral Hemorrhage (ICH) score less than 4 points, the presence of tissue shift, and a Glasgow Coma Scale (GCS) score (excluding language) above 6 points at extubation. By simplifying the prediction model, we obtained the Spontaneous Cerebellar Hemorrhage Extubation Success scoring system (SCHES-SCORE). Within the scoring system, 2 points were allocated for a GCS score (excluding language) above 6 at extubation, 1 point each for age under 66 years and an ICH score below 4, while tissue shift was assigned a negative point. A score of Grade A (SCHES-SCORE = 3-4) was found to correlate with a 92.9% success rate for extubation. The area under the receiver operating characteristic curve was 0.923 (95% CI, 0.863 to 0.983). Notably, successful extubation was significantly linked to reduced durations of mechanical ventilation, intensive care unit (ICU) stay, and total hospital stay. In conclusion, the scoring system developed for assessing extubation outcomes in SCH patients has the potential to enhance the rate of successful extubation and overall patient outcomes.

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来源期刊
Cerebellum
Cerebellum 医学-神经科学
CiteScore
6.40
自引率
14.30%
发文量
150
审稿时长
4-8 weeks
期刊介绍: Official publication of the Society for Research on the Cerebellum devoted to genetics of cerebellar ataxias, role of cerebellum in motor control and cognitive function, and amid an ageing population, diseases associated with cerebellar dysfunction. The Cerebellum is a central source for the latest developments in fundamental neurosciences including molecular and cellular biology; behavioural neurosciences and neurochemistry; genetics; fundamental and clinical neurophysiology; neurology and neuropathology; cognition and neuroimaging. The Cerebellum benefits neuroscientists in molecular and cellular biology; neurophysiologists; researchers in neurotransmission; neurologists; radiologists; paediatricians; neuropsychologists; students of neurology and psychiatry and others.
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