关键词: 低血糖, 糖尿病, 预测, 模型, 系统评价, 护理

Abstract:

Objective We systematically review the hypoglycemia risk prediction models for patients with diabetes mellitus,so as to provide references for nursing practice. Methods A systematic review was conducted. The CNKI,CBM,Wanfang,VIP,PubMed,Embase,Cochrane and CINAHL were searched to collect studies on hypoglycemia risk prediction models from database establishment to 28 December 2021. The reviewer independently screened the literature according to the pre-determined inclusion and exclusion criteria,extracted the data and evaluated the risk of bias of the included studies using the Prediction Model Risk of Bias Assessment Tool. Results A total of 14 pieces of the literature and 16 models were included with the total sample size of 257~ 1 173 820 cases and the outcome events of 72~7 030 cases. All studies reported the area under the receiver operating characteristic curve of the prediction models in the derivation and（or） validation datasets as from 0.63 to 0.96. Among them,12 models reported calibration metrics,and 5 models were externally validated. Independent predictors of multivariable model repeatability were age,history of hypoglycemia,use of insulin and other hypoglycemic drugs,and estimated glomerular filtration rate. Small sample size,lack of internal or external validation,inappropriate variable selection methods,and missing data processing can increase the risk of bias in the studies. Conclusion The overall prediction model of hypoglycemia risk has good performance and low concern for applicability. However,this finding should be interpreted with caution due to the risk of bias in the included studies. Future work should focus on following transparent reporting of multivariable prediction models for individual prognosis or diagnosis to develop and evaluate the hypoglycemia risk score for diabetes and to validate its applicability and feasibility in clinical practice.

Key words: Hypoglycemia, Diabetes Mellitus, Prediction, Model, Systematic Review, Nursing Care