ICU患者压力性损伤风险预测模型的系统评价

doi:10.3761/j.issn.0254-1769.2021.08.020

摘要/Abstract

摘要：

目的系统评价ICU患者压力性损伤风险预测模型,为相关预测模型的构建、应用及优化提供参考依据。方法全面检索Cochrane Library、PubMed、Embase、CHINAL、Web of Science、中国知网、维普、万方和中国生物医学文献数据库中发表的与ICU患者压力性损伤风险预测模型相关的文献,检索时限为建库至2020年12月31日。由2名研究人员严格按照纳入与排除标准独立筛选文献并提取资料,使用预测模型构建研究数据提取和质量评价清单对纳入文献的质量进行评价。结果共纳入15篇文献,包括28个ICU患者压力性损伤风险预测模型,其中20个模型的受试者工作特征曲线下面积在验模过程中均>0.7。性别、年龄、糖尿病史、机械通气、ICU住院时间是进入模型最多的预测因子。结论 ICU患者压力性损伤风险预测模型研究整体质量较高、模型性能好。男性、高龄、有糖尿病史、机械通气、ICU住院时间长是ICU患者发生压力性损伤的高危因素。护理人员应结合临床实际情况选择预测模型,尽早识别压力性损伤风险并采取针对性的预防措施。

关键词: 压力性损伤, 重症监护病房, 预测, 风险, 模型, 护理

Abstract:

Objective To conduct a systematic review of pressure injuries risk prediction models in ICU patients,in order to provide evidence-based references for clinical nurses to conduct pressure injuries prediction models. Methods Cochrane Library, PubMed, Embase,CINAHL, Web of science,CNKI,VIP,Wanfang,and Chinese bio-medical databases were searched for the related studies on pressure injuries risk prediction models in ICU patients from the establishment of the databases to December 31, 2020. 2 researchers were selected to retrieve studies according to the inclusion and exclusion criteria, and critically evaluated the quality of studies based on the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies. Results 15 studies were included, containing 28 pressure injuries risk prediction models. The AUC（area under ROC curve） of 20 models were all over 0.7. Gender,age,diabetes mellitus, mechanical ventilation,length of ICU stay were the most important predictors of pressure injuries. Conclusion Studies of the pressure injury risk prediction model in ICU patients had high research quality, and the risk prediction models also had good predictive performance. Male, the aged, history of diabetes,mechanical ventilation and long stay in ICU were high risk factors for pressure injuries in ICU patients. Clinical nurses should choose models with better predictive performance based on clinical practice, so as to provide targeted preventions for patients.

Key words: Pressure Injuries, Intensive Care Units, Prediction, Risk, Models, Nursing Care

贾盈盈,张红燕,马媛媛,邓露,何博,燕芳红,韩琳,马玉霞. ICU患者压力性损伤风险预测模型的系统评价[J]. 中华护理杂志, 2021, 56(8): 1242-1248.

JIA Yingying,ZHANG Hong-yan,MA Yuanyuan,DENG Lu,HE Bo,YAN Fanghong,HAN Lin,MA Yuxia. Systematic review of pressure injuries risk prediction models in ICU patients[J]. Chinese Journal of Nursing, 2021, 56(8): 1242-1248.

图/表 4

表1 纳入文献的基本特征

Table 1 Characteristics of included studies

表2 纳入文献的方法学质量评价

Table 2 Risk of bias assessment for included studies

表3 ICU患者压力性损伤风险预测模型的基本特征

Table 3 Characteristics of pressure injuries risk prediction models in ICU patients

表4 前5位预测因子Meta分析结果

Table 4 Meta-analysis of the top five predictive factors

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