摘要
目的系统检索并评价肠内营养患者误吸风险的预测模型,为后续模型的开发和应用提供参考依据。方法检索中国知网、万方数据库、中国生物医学文献数据库、Web of Science、Cochrane Library、Embase、PubMed中收录的肠内营养患者误吸风险预测模型相关文献,检索时限为建库到2024年8月30日。由2名研究者独立完成文献筛选和资料提取,使用PROBAST工具评价纳入研究的偏倚性和适用性。结果共纳入18项研究,涉及24个预测模型,样本量为103~512,结局事件发生率为9.46%~49.87%。基线年龄、误吸史、鼻饲管置入长度、营养风险、意识障碍、急性生理和慢性健康状况Ⅱ评分是各模型重复报告的前6个预测变量。模型受试者工作特征曲线下面积为0.756~0.992;12项研究报告了模型校准度;6项研究仅行内部验证,1项研究仅行外部验证,4项研究内外部验证相结合。18项研究整体适用性评价较好,但偏倚风险较高,主要原因是连续变量和缺失数据处理方式不合理。结论各研究构建的肠内营养患者误吸风险预测模型具有良好的适用性,但存在较高的偏倚风险。未来仍需从模型构建过程、内外部验证和结果分析等方面进一步优化,为临床提供更加可靠和科学的误吸风险评估工具。
Objective To systematically review and evaluate prediction models for aspiration risk in enteral nutrition patients,providing a reference for the development and application of future models.Methods Literature related to prediction models for aspiration risk in enteral nutrition patients was searched in China National Knowledge Infrastructure,Wanfang Data,China Biology Medicine disc,Web of Science,Cochrane Library,Embase,and PubMed,with the search period covering from the inception of the databases to August 30,2024.Two researchers independently conducted literature screening and data extraction,and the PROBAST tool was used to assess the risk of bias and applicability of the included studies.Results A total of 18 studies were included,involving 24 prediction models,with sample sizes ranging from 103 to 512 and an event rate of 9.46%to 49.87%.The top six predictive variables reported most frequently were baseline age,history of aspiration,length of nasogastric tube insertion,nutritional risk,impaired consciousness,and Acute Physiology and Chronic Health Evaluation-Ⅱscore.The area under the receiver operating characteristic curve of the models ranged from 0.756 to 0.992.Twelve studies reported model calibration,six studies conducted internal validation only,one study conducted external validation only,and four studies performed both internal and external validation.The overall applicability of the 18 studies was good,but the risk of bias was high,mainly due to improper handling of continuous variables and missing data.Conclusions The aspiration risk prediction models developed in various studies for enteral nutrition patients show good applicability but carry a high risk of bias.Future efforts should focus on further optimizing the model construction process,internal and external validation,and result analysis to provide more reliable and scientific tools for clinical aspiration risk assessment.
作者
邓裕梅
李昌秀
周静
周文林
罗吉美
周冰雪
马莉娜
Deng Yumei;Li Changxiu;Zhou Jing;Zhou Wenlin;Luo Jimei;Zhou Bingxue;Ma Lina(School of Nursing,Zunyi Medical University,Guizhou 563000,China;Department of Nursing,the Second Affiliated Hospital of Zunyi Medical University,Guizhou 563000,China;Department of Nursing,Affiliated Hospital of Zunyi Medical University,Guizhou 563000,China)
出处
《中华现代护理杂志》
2025年第29期3989-3997,共9页
Chinese Journal of Modern Nursing
基金
国家自然科学基金(82360289)
贵州省科学技术厅基础研究(黔科合基础-ZK[2022]一般645)
贵州省卫生健康委科学技术基金(gzwkj2022-246)。
关键词
系统评价
肠内营养
误吸
预测模型
循证护理
Systematic review
Enteral nutrition
Aspiration
Prediction model
Evidence-based nursing
