%0杂志文章%@ 2561- 7605% I JMIR出版物%V 6%卡塔尔世界杯8强波胆分析 N %P e43130% T养老院严重程度指数及其在压力损伤风险中的应用:测量开发和验证研究%A Yap,Tracey L %A Horn,Susan D %A Sharkey,Phoebe D %A Brooks,Katie R %A Kennerly,Susan +杜克大学护理学院，311 Trent Drive, DUMC 3322, Durham, NC, 27710，美国，1 (919)613 6170，tracey.yap@duke.edu %K老年病学%K养老院%K压疮%K倾向评分%K病情严重程度指数%K发展%K验证%K临床%K治疗%K压伤%K损伤%K风险%K预防%D 2023 %7 9.2.2023 %9原始论文%J JMIR老化%G英文%X背景:需要一种评估工具来衡量养老院居民的临床严重程度，以改善预后预测，并为治疗计划提供指导。目的:本研究旨在描述养老院严重程度指数的发展，这是一种针对养老院居民的临床严重程度测量，有可能针对不同的结果进行个性化定制，如压力损伤。方法:采用回顾性非实验设计，使用来自9家疗养院的辅助数据，开发并验证疗养院严重程度指数，这些疗养院参与了12个月前干预期的Turn Everyone and Move for溃疡预防(TEAM-UP)实用临床试验。使用专家意见和临床文献来确定指标，这些指标被分为严重程度维度。利用来自养老院电子健康记录、最小数据集和风险管理系统的二级数据，完成了预测压力损伤风险的指标表现和验证。逻辑回归模型包括居民的最差-布雷登评分(带/不带严重程度维度)生成倾向评分。采用C统计量评估整体模型的拟合优度;采用似然比卡方检验确定在模型中加入严重程度分量后拟合改善的显著性。 The significance of each component was assessed with odds ratios. Validation based on randomly selected 65% training and 35% validation data sets was used to confirm the reliability of the severity measure. Finally, the discriminating ability of models was evaluated using propensity stratification to evaluate which model best discriminated between residents with/without pressure injury. Results: Data from 1015 residents without pressure injuries on admission were used for the Nursing Home Severity Index–Pressure Injury and included laboratory, weights/vitals/pain, underweight, and locomotion severity dimensions. Logistic regression C statistic measuring predictive accuracy increased by 19.3% (from 0.627 to 0.748; P<.001) when adding four severity dimensions to Worst-Braden scores. Significantly higher odds of developing pressure injuries were associated with increasing dimension scores. The use of the three highest propensity deciles predicting the greatest risk of pressure injury improved predictive accuracy by detecting 21 more residents who developed pressure injury (n=58, 65.2% vs n=37, 42.0%) when both severity dimensions and Worst-Braden score were included in prediction modeling. Conclusions: The clinical Nursing Home Severity Index–Pressure Injury was successfully developed and tested using the outcome of pressure injury. Overall predictive capacity was enhanced when using severity dimensions in combination with Worst-Braden scores. This index has the potential to significantly impact the quality of care decisions aimed at improving individual pressure injury prevention plans. Trial Registration: ClinicalTrials.gov NCT02996331; http://clinicaltrials.gov/ct2/show/NCT02996331 %M 36757779 %R 10.2196/43130 %U https://aging.www.mybigtv.com/2023/1/e43130 %U https://doi.org/10.2196/43130 %U http://www.ncbi.nlm.nih.gov/pubmed/36757779