元医生智能体/呼吸/知识库
文献速递肺栓塞

恶性胸腔积液抽吸术后下次操作时间的预测：RED评分的推导与初步验证

Time to next procedure in patients with malignant pleural effusion undergoing aspiration: derivation and initial validation of the RED score
RSS 订阅 · Thorax

本研究为英国10家医院的前瞻性观察性队列研究，纳入241例已知或疑似恶性胸腔积液（MPE）患者，随访3个月评估下次临床所需胸腔操作的时间。结果显示基线呼吸频率（R）、超声胸水深度（E）和视觉模拟呼吸困难评分（D）组成的RED评分可独立预测下次操作时间，推导队列ROC曲线下面积为0.73和0.75，外部验证队列（n=31、n=57）显示合理预测价值。

要点

  • RED评分由基线呼吸频率、超声胸水深度和呼吸困难VAS评分组成，可预测MPE抽吸后下次操作时间
  • 推导队列（n=180）中，RED评分的ROC曲线下面积为0.73和0.75，验证队列预测价值合理
  • 适用于已知或疑似恶性胸腔积液患者，帮助个体化安排随访和操作计划

核心结论

  • 在恶性胸腔积液患者中，基线呼吸频率、超声胸水深度和呼吸困难评分可预测下次胸腔操作的时间

研究设计与样本

  • 前瞻性观察性队列研究，在英国10家医院进行
  • 纳入241例已知或疑似恶性胸腔积液并接受治疗性抽吸的患者
  • 随访3个月，评估下次临床指征性胸腔操作的时间

主要发现

  • 推导队列（n=180）中，基线呼吸频率、超声胸水深度、呼吸困难VAS评分是下次操作时间的独立预测因子
  • 预测模型的ROC曲线下面积为0.73和0.75
  • 两个外部验证队列（n=31，n=57）显示合理的预测价值

关键数值与推荐

  • RED评分由呼吸频率（R）、超声胸水深度（E）和呼吸困难VAS（D）三项组成

临床怎么用

  • 可用于临床评估恶性胸腔积液患者抽吸后需要再次操作的风险，帮助制定随访计划

局限性

  • 本研究未报告具体阈值、剂量、样本量区间或P值等细节，验证队列样本量较小

以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。

原文

Introduction In patients with malignant pleural effusions (MPE), pleural fluid reaccumulates at variable rates following therapeutic aspiration. The aim of this study was to identify variables which predict time to next procedure and use them to develop a predictive score. Methods This prospective observational cohort study in 10 British hospitals recruited patients with known or suspected malignant effusions undergoing therapeutic aspiration. Follow-up lasted 3 months and assessed time to next clinically indicated pleural procedure. Regression analysis was performed to identify independent variables predicting time to next procedure, and a score derived. Initial validation was done in two external cohorts. Measurements and main results 241 patients were recruited. Within the derivation cohort (n=180), baseline respiratory rate (R), pleural effusion depth on ultrasound (E) and dyspnoea measured using a visual analogue scale (D) (combined to form the RED score) were independent predictors of time to next procedure. Predictive models provided areas under the receiver operator curve of 0.73 and 0.75. Initial validity testing in two cohorts (n=31, n=57) demonstrated reasonable predictive value. Conclusions In patients with MPE, baseline respiratory rate, pleural effusion depth on ultrasound and dyspnoea predict time to next procedure. Trial registration number ISRCTN16567838 .

来源：Thorax，查看原文。版权归原作者所有。

引用

  1. Thorax：Time to next procedure in patients with malignant pleural effusion undergoing aspiration: derivation and initial validation of the RED score
在智能体中追问阅读原文 ↗

供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。