Improvement of a clinical prediction rule for clinical trials on prophylaxis for invasive candidiasis in the intensive care unit
Improvement of a clinical prediction rule for clinical trials on prophylaxis for invasive candidiasis in the intensive care unit
复制标题
DOI：
10.1111/j.1439-0507.2009.01756.x
复制
发表时间：
2011-01-01
期刊：
影响因子：
4.9
通讯作者：
Sobel, Jack D.
中科院分区：
文献类型：
--
作者：
Ostrosky-Zeichner, Luis;Pappas, Peter G.;Sobel, Jack D.
我们创建了一个临床预测规则来识别重症监护室（ICU）中有侵袭性念珠菌病（IC）风险的患者（欧洲临床微生物学感染与疾病杂志2007; 26：271）。该规则适用于< 10% of patients in ICUs. We sought to create a more inclusive rule for clinical trials. Retrospective review of patients admitted to ICU >= 4天，收集风险因素和结果。基于引入机械通气和风险因素的规则的变化进行了评估。我们回顾了597例患者，平均APACHE II评分为14.4，平均ICU停留时间为12.5天，平均通气时间为10.7天。第1-3天需要机械通气和中心静脉导管和广谱抗生素的规则变化以及18%的患者适用的额外风险因素，将IC的发生率维持在10%。对我们原来的规则进行修改，使研究规则更具包容性。
P>We created a clinical prediction rule to identify patients at risk of invasive candidiasis (IC) in the intensive care unit (ICU) (Eur J Clin Microbiol Infect Dis 2007; 26:271). The rule applies to < 10% of patients in ICUs. We sought to create a more inclusive rule for clinical trials. Retrospective review of patients admitted to ICU >= 4 days, collecting risk factors and outcomes. Variations of the rule based on introduction of mechanical ventilation and risk factors were assessed. We reviewed 597 patients with a mean APACHE II score of 14.4, mean ICU stay of 12.5 days and mean ventilation time of 10.7 days. A variation of the rule requiring mechanical ventilation AND central venous catheter AND broad spectrum antibiotics on days 1-3 AND an additional risk factor applied to 18% of patients, maintaining the incidence of IC at 10%. Modification of our original rule resulted in a more inclusive rule for studies.