儿童社区获得性肺炎死亡风险评估量表Meta分析
Meta-Analysis of Prognostic Scales to Estimate the Mortality of Community-Acquired Pneumonia in Children
DOI: 10.12677/SA.2023.123075, PDF,    科研立项经费支持
作者: 龙 鑫, 汪骊郦#, 李婉玲, 罗征秀, 罗 健, 符 州, 刘恩梅*, 邓 昱*：重庆医科大学附属儿童医院呼吸科，国家儿童健康与疾病临床医学研究中心，儿童发育疾病研究教育部重点实验室，儿童感染免疫重庆市重点实验室，重庆
关键词: 儿童；社区获得性肺炎；死亡；危险因素；量表；Meta分析；Children； Community-Acquired Pneumonia； Death； Risk Factors； Scales； Meta-Analysis
摘要: 系统评价儿童肺炎死亡危险因素，检验现有肺炎患儿死亡风险量表指标合理性，为儿童肺炎死亡预测模型优化提供参考。检索Web of Science、Embase、PubMed、Cochrane、万方及中国知网数据库建库至2023年2月27日有关儿童肺炎死亡危险因素的研究，采用RevMan5.4软件进行Meta分析。纳入29篇研究，共68707例患者，结果显示：在RISC评分中低氧血症、营养不良及PERCH评分中年龄 < 1岁、无应答、低氧血症、营养不良被证明与死亡有关；Florin模型、PCIS中指标未被验证与死亡相关；儿童版PIRO量表中伴随疾病、缺氧、多叶肺炎被证明与死亡有关。目前用于评估儿童CAP死亡风险的量表中，部分指标被验证与不良预后相关。现有风险量表仍需进一步外部验证，以得到更具适用、实用、准确性的预测模型，为临床决策提供参考。
Abstract: Systematically evaluate the risk factors for death and validate the rationality of indexes of existing prognostic scales for mortality in children with Community-acquired Pneumonia to provide a reference for the optimization of prognostic models in children with CAP. Web of Science, Embase, PubMed, The Cochrane Library, Wanfang database, and CNKI database were electronically searched to collect studies related to risk factors for death in children with CAP from the inception to February 27th, 2023, a meta-analysis was performed using Review Manager 5.4 software. A total of 29 studies involving 68707 patients were included. The Meta-analysis shows: Hypoxemia and malnutrition in RISC score were associated with increased risk factors of death among children with CAP. In PERCH score, age younger than 1 year, Unresponsiveness, hypoxemia and malnutrition were associated with increased risk factors of death. Indexes in Florin’s model and PCIS were not validated to be associated with death. Comorbidity, hypoxia and multilobar pneumonia in the modified PIRO scale in children with CAP were associated with death. Some indexes of existing scales used to assess the risk of death among children with CAP have been validated to be associated with poor prognosis. Further external validation of existing Prognostic scales is still needed to obtain more applicable, practical, and accurate prediction models for clinical decision-making.
文章引用：龙鑫, 汪骊郦, 李婉玲, 罗征秀, 罗健, 符州, 刘恩梅, 邓昱. 儿童社区获得性肺炎死亡风险评估量表Meta分析[J]. 统计学与应用, 2023, 12(3): 706-723. https://doi.org/10.12677/SA.2023.123075

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