抽象
A strategy of early extubation to noninvasive respiratory support in preterm infants could be boosted by the availability of a decision support tool for clinicians. Using the Heart Rate Characteristics index (HRCi) with clinical parameters, we derived and validated predictive models for extubation readiness and success.
Peri-extubation demographic, clinical and HRCi data for up to 96 h were collected from mechanically ventilated infants in the control arm of a randomised trial involving eight neonatal centres, where clinicians were blinded to the HRCi scores. The data were used to produce a multivariable regression model for the probability of subsequent re-intubation. Additionally, a survival model was produced to estimate the probability of re-intubation in the period after extubation.
Of the 577 eligible infants, data from 397 infants (69%) were used to derive the pre-extubation model and 180 infants (31%) for validation. The model was also fitted and validated using all combinations of training (five centres) and test (three centres) centres. The estimated probability for the validation episodes showed discrimination with high statistical significance, with an area under the curve of 0.72 (95% CI 0.71–0.74; p<0.001). Data from all infants were used to derive models of the predictive instantaneous hazard of re-intubation adjusted for clinical parameters.
使用生理和临床变量,可以导出拔除准备和成功的预测模型。可以使用可用的在线工具访问我们分析中的模型www.heroscore.com/extubation., and have the potential to inform and supplement the confidence of the clinician considering extubation in preterm infants.
抽象
使用心率特征指数,我们具有预测早产婴儿的拔管结果的模型,无论是拔管准备和成功。这些模型旨在作为临床医生的决策支持工具。https://bit.ly/2lknekk.
脚注
本文提供了补充材料www.qdcxjkg.com.
Author contributions: M. Chakraborty conceptualised the study, analysed and interpreted data, wrote and revised drafts of the manuscript, and approved the final draft. W.J. Watkins analysed and interpreted data, wrote code for online applications, revised drafts of the manuscript, and approved the final draft. K. Tansey analysed data, wrote code for online applications and approved the final draft. W.E. King collected original data, revised drafts of the manuscript and approved the final draft. S. Banerjee conceptualised the study, interpreted data, revised drafts of the manuscript and approved the final draft; this author had full access to all the data in the study and had final responsibility for the decision to submit for publication.
利益冲突:W.J. Watkins没有什么可披露的。
Conflict of interest: K. Tansey has nothing to disclose.
利益冲突:W.E.国王向提交的工作之外的医疗预测科学公司(MPSC)报告个人费用,并获得薪水和股票作为MPSC,英雄制造商的首席执行官。
利益冲突:S. Banerjee没有披露。
Conflict of interest: M. Chakraborty has nothing to disclose.
Support statement: M. Chakraborty was supported by a personal research grant (Clinical Research Time Award CTRA-16–04) from Health and Care Research Wales (HCRW). HCRW had no role in the study design, analysis or interpretation of data. Funding information for this article has been deposited with theCrossref Funder Registry.
- 收到2019年4月28日。
- Accepted5月15日,2020年。
- 复制right ©ERS 2020