| 摘要: |
| 目的 探讨ROX指数在脓毒症患者经鼻高流量湿化氧疗（High-Flow Nasal Cannula, HFNC）失败中的预测价值。 方法 本研究采用病例-对照研究设计，所有数据来源于美国重症监护医学信息数据库IV（Medical Information Mart for Intensive Care IV, MIMIC-IV）。通过Lasso回归和多因素Logistic回归分析，探索HFNC失败的独立危险因素，并使用受试者工作特征（Receiver Operating Characteristic, ROC）曲线、Hosmer-Lemeshow检验（HL检验）、校准曲线、决策曲线分析（Decision Curve Analysis, DCA）和临床影响曲线（Clinical Impact Curve, CIC）来评估ROX指数的临床效能。 结果 本研究共纳入316例符合标准的脓毒症患者，其中116例发生HFNC失败。Lasso回归和多因素Logistic回归分析显示，ROX指数是HFNC失败的独立危险因素。在HFNC治疗12小时后，ROX指数预测HFNC失败的ROC曲线下面积（Area Under Curve, AUC）为0.761。HL检验显示卡方值7.36，P值0.60，校准曲线接近理想对角线，DCA和CIC显示其具有良好的临床应用价值。 结论 ROX指数对预测脓毒症患者HFNC失败具有良好的价值，显示出一定的临床应用前景。 |
| 关键词: HFNC 脓毒症 ROX指数 |
| DOI： |
| 分类号: |
| 基金项目:温州市基础性公益科研项目 |
|
| The Predictive Value of the ROX Index in High-Flow Nasal Cannula Failure Among Sepsis Patients |
|
WEI Xiaowu1, YE Yuanwen2, LIfeifei2, YANGBaohua2, LINliangen2, CHENlinglong2
|
|
1.Zhejiang Chinese Medical University;2.Wenzhou People’s Hospital
|
| Abstract: |
| Objective To assess the predictive value of the ROX index in predicting High-Flow Nasal Cannula (HFNC) therapy failure among sepsis patients. Methods A case-control design was adopted in this study, with data sourced from the Medical Information Mart for Intensive Care IV (MIMIC-IV). Lasso regression and multivariate logistic regression analyses were performed to identify independent risk factors for HFNC failure. The clinical efficacy of the ROX index was evaluated through the Receiver Operating Characteristic (ROC) curve, Hosmer-Lemeshow (HL) test, calibration curve, Decision Curve Analysis (DCA), and Clinical Impact Curve (CIC). Results A total of 316 eligible sepsis patients were included in the study, of whom 116 experienced HFNC failure. Lasso regression and multivariate logistic regression analyses identified the ROX index as a significant independent risk factor for HFNC failure. After 12 hours of HFNC therapy, the Area Under the Curve (AUC) of the ROX index for the prediction of HFNC failure was 0.761. The HL test showed a chi-square value of 7.36 with a P-value of 0.60, and the calibration curve was near the ideal diagonal. DCA and CIC indicated good clinical utility. Conclusion The ROX index has significant potential in predicting HFNC failure among sepsis patients, indicating its usefulness in clinical application. |
| Key words: HFNC sepsis ROX index |