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Thorax：PEARL评分可以预测COPD急性加重期患者90天内的再住院或死亡风险！！！

2017-02-25 xing.T MedSci原创

PEARL评分COPD急性加重期90天内再住院或死亡风险
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由此可见，PEARL评分是一个简单的工具，可以有效地将患者90天再入院或死亡的风险进行分层，这可能在临床和研究中可以帮助指导再住院的规避策略。而且PEARL评分优于该人群所用的其他评分。

约有三分之一因COPD急性加重期（AECOPD）的住院患者在90天内往往需要再次入院治疗 。但是对于这类人群还没有特异性的工具来预测他们再住院或死亡风险。临床医生无法确定具有特定风险的患者，而且预防再入院资源的分配也不是基于临床判断。近日，胸部疾病领域权威杂志Thorax上发表了一篇研究文章，研究人员旨在介绍一种评分来预测AECOPD患者90天内的再住院或死亡风险。

在参与研究的医院中，通过筛查病房和审核编写的病例来确定连续就诊的AECOPD患者。在两个医院中（推导队列）开发了一个来预测90天再入院或没有再住院死亡的工具，并且在两个队列中进行验证：（a）在稍后的时间内同一医院（内部验证队列）和（b）4个英国医院（外部验证队列）。其性能与ADO、BODEX、CODEX、DOSE和LACE评分进行比较。

研究人员发现在2417例患者中，936人在出院90 天内再入院或死亡。在最终的模型中包含的五个独立变量为：以往的住院情况、eMRCD评分、年龄、右心衰竭、左心衰竭（PEARL）。PEARL评分具有一致的判别性和准确性，在推导队列、内部验证队列和外部验证队列中其C-统计量分别为0.73、0.68和0.70。PEARL评分较高者与再入院的时间更短相关。

由此可见，PEARL评分是一个简单的工具，可以有效地将患者90天再入院或死亡的风险进行分层，这可能在临床和研究中可以帮助指导再住院的规避策略。而且PEARL评分优于该人群所用的其他评分。

原始出处：

C Echevarria, et al. The PEARL score predicts 90-day readmission or death after hospitalisation for acute exacerbation of COPD.Thorax. 2017.http://dx.doi.org/10.1136/thoraxjnl-2016-209298

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    2017-12-23 minzju5052

    #急性加重#

    0

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    2017-12-22 xinmeili

    #急性加重期#

    0

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    2017-05-28 feather89

    #PE#

    0

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    2017-02-27 quxin068

    #死亡风险#

    0

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    2017-02-26 1e10eabem79(暂无匿称)

    慢支炎，肺气肿，这种多发病，在预后方面的研究有了可喜的进步

    0

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