慢性意识障碍患者结局预测模型的系统综述

Prediction models of outcome for patients with prolonged disorders of consciousness:a systematic review

目的系统评价慢性意识障碍患者结局预测模型的组成因子和准确率。方法采用主题词检索方式,检索PubMed、Web of Science、中国知网、万方数据建库至2021年9月30日慢性意识障碍患者结局预测模型的相关文献,提取内容为作者、出版年份、研究对象、监测项目、主要结局指标和结论。结果共返回文献4313篇,最终纳入37篇,文献类型包括随机对照试验、队列研究,发表时间主要集中在2012年至2021年,研究对象为慢性意识障碍患者,预测模型的组成因子包括临床量表、神经影像学检查、神经电生理学检查和实验室指标。结论预测模型对慢性意识障碍患者的远期结局有一定的参考价值。目前的预测模型大多数只由有限的一项或几项技术手段构成,准确率参差不齐,其中昏迷恢复量表修订版、默认网络、联合多种诱发电位的脑电图分析相关的预测模型具有较高准确率,但尚未建立统一的适配标准。

Objective To systematicly evaluate the constituent factors and accuracy of prediction models of outcome for patients with prolonged disorders of consciousness.Methods Articles about prediction models of outcome for patients with prolonged disorders of consciousness were retrieved from PubMed,Web of Science,CNKI and Wanfang Data until September 30 th,2021.The authors,publishing times,subjects,predictive indicators,outcomes and conclusions were extracted.Results A total of 4313 articles were returned and 37 included,comprising randomized controlled trials and cohort studies,which published mainly from 2012 to 2021.The subjects were patients with prolonged disorders of consciousness,and their predictions consisted of clinical assessment scales,neuroimaging,neuroelectrophysiology and laboratory indicators.Conclusion Prediction models may be valuable for the long-term outcomes of patients with prolonged disorders of consciousness.Most of the current prediction models are composed of only a limited number of technical means,and the accuracy is uneven.Coma Recovery Scale-revised,default mode network and multiple evoked potentials-related prediction models are accurate,but lack a unified adaptation standard.