癌症患者非计划性再入院风险预测模型的范围综述

A scoping review of models for predicting the risk of unplanned readmission in cancer patients

目的对癌症患者非计划性再入院的风险预测模型进行范围综述,为临床护理工作及未来研究提供借鉴。方法聚焦癌症患者非计划性再入院风险预测模型,系统检索中英文数据库,提取适用人群、非计划性再入院发生率、模型构建的方法学、预测因子及性能等信息。结果共纳入18项研究,涉及23个模型,研究人群集中于结直肠癌术后患者。癌症患者30 d内非计划性再入院的发生率为8.2%~19.0%。模型构建的方法多样,但预测性能总体表现欠佳。合并症、肿瘤分期、住院时长、年龄和术后并发症是预测癌症患者非计划性再入院的重要因子。结论临床护理人员应关注非计划性再入院的高危因素,选择性能优良的工具指导临床实践。未来可借助人工智能技术,构建预测性能佳、可操作性强的模型,并进行广泛的外部验证。

Objective A scoping review of unplanned readmission(UR)risk prediction models for cancer patients was conducted to provide a basis for clinical practice and research.Methods The UR risk prediction model of cancer patients was focused,and the Chinese and English databases were searched systematically.The extracted information of the model included applicable population,the incidence of UR,modeling methodology,predictors of the model and their performance.Results 18 studies involving 23 prediction models were included and the population focused on postoperative colorectal cancer patients.The incidence of 30 days UR in cancer patients ranged from 8.2%to 19.0%.The model development methods were various,but the overall prediction performance was poor.Comorbidities,TNM,length of stay,age and postoperative complications were important predictors of UR in cancer patients.Conclusion Clinical staff should pay attention to UR risk factors and choose excellent tools to guide clinical practice.Prediction models with high predictive performance and operability can be developed with artificial intelligence and verified extensively and externally.