New integrated weaning indices from mechanical ventilation: A derivation-validation observational multicenter study.
cut-off values
likelihood ratio
mechanical ventilation
receiver-operating characteristic curve
weaning indices
Journal
Frontiers in medicine
ISSN: 2296-858X
Titre abrégé: Front Med (Lausanne)
Pays: Switzerland
ID NLM: 101648047
Informations de publication
Date de publication:
2022
2022
Historique:
received:
07
12
2021
accepted:
06
07
2022
entrez:
8
8
2022
pubmed:
9
8
2022
medline:
9
8
2022
Statut:
epublish
Résumé
To develop ten new integrated weaning indices that can predict the weaning outcome better than the traditional indices. This retrospective-prospective derivation-validation observational multicenter clinical trial (Clinical Trial.Gov, NCT01779297), was conducted on 1,175 adult patients admitted at 9 academic affiliated intensive care units (ICUs; 4 surgical and 5 medical), from Jan 2013 to Dec 2018. All patients, intubated and mechanically ventilated for at least 24 h and ready for weaning were enrolled. The study had two phases: at first, the threshold values of each index that best discriminate between a successful and an unsuccessful weaning outcome was determined among 208 patients in the derivation group. In the second phase, the predictive performance of these values was prospectively tested in 967 patients in the validation group. In the prospective-validation set we used Bayes' theorem to assess the probability of each test in predicting weaning. In the prospective validation group, sensitivity, specificity, diagnostic accuracy, positive and negative predictive values, and finally area under the receiver operator characteristic curves and standard errors for each index (ten formulae) were calculated. Statistical values of ten formulae for aforesaid variables were higher than 87% (0.87-0.99). The new indices can be used for hospitalized patients in intensive care settings for accurate prediction of the weaning outcome.
Sections du résumé
Background
UNASSIGNED
To develop ten new integrated weaning indices that can predict the weaning outcome better than the traditional indices.
Methods
UNASSIGNED
This retrospective-prospective derivation-validation observational multicenter clinical trial (Clinical Trial.Gov, NCT01779297), was conducted on 1,175 adult patients admitted at 9 academic affiliated intensive care units (ICUs; 4 surgical and 5 medical), from Jan 2013 to Dec 2018. All patients, intubated and mechanically ventilated for at least 24 h and ready for weaning were enrolled. The study had two phases: at first, the threshold values of each index that best discriminate between a successful and an unsuccessful weaning outcome was determined among 208 patients in the derivation group. In the second phase, the predictive performance of these values was prospectively tested in 967 patients in the validation group. In the prospective-validation set we used Bayes' theorem to assess the probability of each test in predicting weaning.
Results
UNASSIGNED
In the prospective validation group, sensitivity, specificity, diagnostic accuracy, positive and negative predictive values, and finally area under the receiver operator characteristic curves and standard errors for each index (ten formulae) were calculated. Statistical values of ten formulae for aforesaid variables were higher than 87% (0.87-0.99).
Conclusion
UNASSIGNED
The new indices can be used for hospitalized patients in intensive care settings for accurate prediction of the weaning outcome.
Identifiants
pubmed: 35935785
doi: 10.3389/fmed.2022.830974
pmc: PMC9354807
doi:
Types de publication
Journal Article
Langues
eng
Pagination
830974Informations de copyright
Copyright © 2022 Vahedian-Azimi, Gohari-Moghadam, Rahimi-Bashar, Samim, Khoshfetrat, Mohammadi, de Souza and Mahmoodpoor.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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