JAMA Intern Med:钟南山团队建立新冠肺炎危重症预测模型 准确性达88%

2020-05-16 MedSci MedSci原创

广州呼吸健康研究院14日发布消息称,中国工程院院士钟南山团队代表中国国家卫生健康委员会高级别专家组,整合临床风险因素,建立新冠肺炎的危重症预测模型,可预测新冠肺炎患者是否会发展为危重症,准确性达到88

广州呼吸健康研究院14日发布消息称,中国工程院院士钟南山团队代表中国国家卫生健康委员会高级别专家组,整合临床风险因素,建立新冠肺炎的危重症预测模型,可预测新冠肺炎患者是否会发展为危重症,准确性达到88%。相关论文近日发表于国际权威杂志《JAMA Internal Medicine》,通讯作者为钟南山、广州呼吸健康研究院院长何建行。据介绍,严重的新冠肺炎可以致死,其中6%-8%的确诊新冠肺炎患者会发展为危重症,需要接受插管通气或者ICU监护,而这些危重的患者死亡率可高达65%。在疾病前期及早识别出具有转变为危重症的风险的患者,及时加强监护,有助于改善患者的预后,对医疗资源的分配也有重要的意义。

严重的新冠肺炎可以致死,其中6%至8%的确诊新冠肺炎患者会发展为危重症,需要接受插管通气或者ICU监护,而这些危重的患者死亡率可高达65%。在疾病前期及早识别出具有转变为危重症的风险的患者,及时加强监护,有助于改善患者的预后,对医疗资源的分配也有重要的意义。

该模型的建立是基于中国1590例新冠肺炎患者,通过LASSO回归对72个临床因素进行筛选,发现10个关键的独立风险因子,包括:胸部X光异常、年龄、咯血、气促、意识障碍、基础疾病数量、既往癌症史、中性粒细胞与淋巴细胞比值、乳酸脱氢酶和直接胆红素。

随后根据每个风险因子的权重构建多因素预测模型,内部验证准确度达到88%。此外,在分别来自武汉、大冶、佛山多家医院共710例的患者中进行外部验证,准确性在88%到98%之间。

据介绍,该预测模型使用简便,能够为每一位患者提供个体化的预测概率,低危组后续发展为危重症的风险仅为0.7%,而高危组则高达59.3%,可用于患者就诊时的分流处理,提高医疗资源分配的效率。

下一步,广州呼吸健康研究院与腾讯成立的人工智能联合实验室,将扩展新冠肺炎等呼吸疾病的大数据研究,研发更多精准实用的临床工具。

在线使用本预测工具:新冠肺炎(COVID-19)住院后重症风险预测工具(COVID-GRAM)


Liang W, Liang H, Ou L, Chen B, Chen A, Li C, Li Y, Guan W, Sang L, Lu J, Xu Y, Chen G, Guo H, Guo J, Chen Z, Zhao Y, Li S, Zhang N, Zhong N, He J; China Medical Treatment Expert Group for COVID-19. Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients With COVID-19. JAMA Intern Med. 2020 May 12:e202033. doi: 10.1001/jamainternmed.2020.2033.原始出处:

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    2021-03-09 王者的眼神

    0

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    2020-05-18 智慧医人
  5. [GetPortalCommentsPageByObjectIdResponse(id=1905980, encodeId=e4a01905980c7, content=<a href='/topic/show?id=34953120e52' target=_blank style='color:#2F92EE;'>#准确性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31207, encryptionId=34953120e52, topicName=准确性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=512a199, createdName=lilianxiang, createdTime=Thu Jul 30 02:59:48 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946752, encodeId=b558946e526e, content=牛, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210309/8cdb67009a5a436cb10e54131a6d0023/05e8b899d2b749eeb9226d900f97d5f4.jpg, createdBy=9a4e5438173, createdName=王者的眼神, createdTime=Tue Mar 09 12:20:07 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262784, encodeId=a6ec1262e848e, content=<a href='/topic/show?id=52941002359d' target=_blank style='color:#2F92EE;'>#预测模型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100235, encryptionId=52941002359d, topicName=预测模型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3ff68, createdName=维他命, createdTime=Mon May 18 06:59:48 CST 2020, time=2020-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610489, encodeId=5551161048971, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Mon May 18 06:59:48 CST 2020, time=2020-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=382882, encodeId=b16038288204, content=牛,可以在线使用, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Sat May 16 20:10:59 CST 2020, time=2020-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028039, encodeId=da2d1028039d4, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Sat May 16 18:59:48 CST 2020, time=2020-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036096, encodeId=8f9810360969a, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat May 16 18:59:48 CST 2020, time=2020-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047810, encodeId=bfd4104e81050, content=梅斯里提供了很多疾病的模型计算公式,赞一个!, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sat May 16 18:59:48 CST 2020, time=2020-05-16, status=1, ipAttribution=)]
    2020-05-16 lovetcm

    牛,可以在线使用

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1905980, encodeId=e4a01905980c7, content=<a href='/topic/show?id=34953120e52' target=_blank style='color:#2F92EE;'>#准确性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31207, encryptionId=34953120e52, topicName=准确性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=512a199, createdName=lilianxiang, createdTime=Thu Jul 30 02:59:48 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946752, encodeId=b558946e526e, content=牛, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210309/8cdb67009a5a436cb10e54131a6d0023/05e8b899d2b749eeb9226d900f97d5f4.jpg, createdBy=9a4e5438173, createdName=王者的眼神, createdTime=Tue Mar 09 12:20:07 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262784, encodeId=a6ec1262e848e, content=<a href='/topic/show?id=52941002359d' target=_blank style='color:#2F92EE;'>#预测模型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100235, encryptionId=52941002359d, topicName=预测模型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3ff68, createdName=维他命, createdTime=Mon May 18 06:59:48 CST 2020, time=2020-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610489, encodeId=5551161048971, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Mon May 18 06:59:48 CST 2020, time=2020-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=382882, encodeId=b16038288204, content=牛,可以在线使用, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Sat May 16 20:10:59 CST 2020, time=2020-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028039, encodeId=da2d1028039d4, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Sat May 16 18:59:48 CST 2020, time=2020-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036096, encodeId=8f9810360969a, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat May 16 18:59:48 CST 2020, time=2020-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047810, encodeId=bfd4104e81050, content=梅斯里提供了很多疾病的模型计算公式,赞一个!, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sat May 16 18:59:48 CST 2020, time=2020-05-16, status=1, ipAttribution=)]
    2020-05-16 公卫新人

    新冠肺炎,疫情何时才能消失

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1905980, encodeId=e4a01905980c7, content=<a href='/topic/show?id=34953120e52' target=_blank style='color:#2F92EE;'>#准确性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31207, encryptionId=34953120e52, topicName=准确性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=512a199, createdName=lilianxiang, createdTime=Thu Jul 30 02:59:48 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946752, encodeId=b558946e526e, content=牛, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210309/8cdb67009a5a436cb10e54131a6d0023/05e8b899d2b749eeb9226d900f97d5f4.jpg, createdBy=9a4e5438173, createdName=王者的眼神, createdTime=Tue Mar 09 12:20:07 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262784, encodeId=a6ec1262e848e, content=<a href='/topic/show?id=52941002359d' target=_blank style='color:#2F92EE;'>#预测模型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100235, encryptionId=52941002359d, topicName=预测模型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3ff68, createdName=维他命, createdTime=Mon May 18 06:59:48 CST 2020, time=2020-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610489, encodeId=5551161048971, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Mon May 18 06:59:48 CST 2020, time=2020-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=382882, encodeId=b16038288204, content=牛,可以在线使用, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Sat May 16 20:10:59 CST 2020, time=2020-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028039, encodeId=da2d1028039d4, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Sat May 16 18:59:48 CST 2020, time=2020-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036096, encodeId=8f9810360969a, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat May 16 18:59:48 CST 2020, time=2020-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047810, encodeId=bfd4104e81050, content=梅斯里提供了很多疾病的模型计算公式,赞一个!, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sat May 16 18:59:48 CST 2020, time=2020-05-16, status=1, ipAttribution=)]
    2020-05-16 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1905980, encodeId=e4a01905980c7, content=<a href='/topic/show?id=34953120e52' target=_blank style='color:#2F92EE;'>#准确性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31207, encryptionId=34953120e52, topicName=准确性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=512a199, createdName=lilianxiang, createdTime=Thu Jul 30 02:59:48 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946752, encodeId=b558946e526e, content=牛, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210309/8cdb67009a5a436cb10e54131a6d0023/05e8b899d2b749eeb9226d900f97d5f4.jpg, createdBy=9a4e5438173, createdName=王者的眼神, createdTime=Tue Mar 09 12:20:07 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262784, encodeId=a6ec1262e848e, content=<a href='/topic/show?id=52941002359d' target=_blank style='color:#2F92EE;'>#预测模型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100235, encryptionId=52941002359d, topicName=预测模型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3ff68, createdName=维他命, createdTime=Mon May 18 06:59:48 CST 2020, time=2020-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610489, encodeId=5551161048971, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Mon May 18 06:59:48 CST 2020, time=2020-05-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=382882, encodeId=b16038288204, content=牛,可以在线使用, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c4a5105539, createdName=lovetcm, createdTime=Sat May 16 20:10:59 CST 2020, time=2020-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1028039, encodeId=da2d1028039d4, content=新冠肺炎,疫情何时才能消失, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=公卫新人, createdTime=Sat May 16 18:59:48 CST 2020, time=2020-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036096, encodeId=8f9810360969a, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat May 16 18:59:48 CST 2020, time=2020-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047810, encodeId=bfd4104e81050, content=梅斯里提供了很多疾病的模型计算公式,赞一个!, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sat May 16 18:59:48 CST 2020, time=2020-05-16, status=1, ipAttribution=)]
    2020-05-16 CHANGE

    梅斯里提供了很多疾病的模型计算公式,赞一个!

    0

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