Modified paediatric preoperative risk prediction score to predict postoperative ICU admission in children: a retrospective cohort study
| Autor: | Pei Wang, Qingxia Fu, Xudong Du, Junzheng Wu, Qingquan Lian, Wangning ShangGuan |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | BMJ Open, Vol 10, Iss 3 (2020) |
| Druh dokumentu: | article |
| ISSN: | 2019-0360 2044-6055 |
| DOI: | 10.1136/bmjopen-2019-036008 |
| Popis: | Objective To integrate intrinsic surgical risk into the paediatric preoperative risk prediction score (PRPS) model to construct a more comprehensive risk scoring system (modified PRPS) and improve the prediction accuracy of postoperative intensive care unit (ICU) admission in paediatric patients.Design This was a retrospective study conducted between 1 January and 30 December 2016. Data on age, American Society of Anaesthesiology physical status (ASA-PS), oxygen saturation, prematurity, non-fasted status, severity of surgery and immediate transfer to the ICU after surgery were collected. The modified PRPS was developed by logistic regression in the derivation cohort; it was tested and compared with the paediatric PRPS and ASA-PS by the Hosmer-Lemeshow test, the receiver operating characteristic (ROC) curve and Kappa analysis in the validation cohort.Setting Hospital-based study in China.Participants Paediatric patients (≤14 years) who underwent surgery under general anaesthesia were included, and those who needed reoperation due to surgical complications or stayed in the ICU preoperatively were excluded.Main outcome measure ICU admission rate, defined as any patients’ direct disposition from the operating room to the ICU immediately after the surgery.Results A total of 9261 paediatric patients were included in this study, with 418 patients admitted to the ICU. In the validation cohort, the modified PRPS model fit the test data well (deciles of risk goodness-of-fit χ2=6.84, p=0.077). The area under the ROC curve of the modified PRPS, paediatric PRPS and ASA-PS were 0.963, 0.941 and 0.870, respectively (p |
| Databáze: | Directory of Open Access Journals |
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