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首页> 外文期刊>Journal of Nursing Education and Practice >A prospective evaluation of the Flacker-Kiely One Year Mortality Score and the added value of NT-proBNP
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A prospective evaluation of the Flacker-Kiely One Year Mortality Score and the added value of NT-proBNP

机译：Flacker-Kiely一年死亡率评分和NT-Probnp附加值的预期评价

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Objective: Several mortality indices have been constructed to aid clinical decision making in older adults. We aimed to prospectively validate the Flacker-Kiely (FK) mortality index in a Norwegian nursing home cohort, which has not been done before, and explore whether NT-ProBNP could improve its discriminatory power.Methods: We performed a cohort/mortality study. From November 2017 to July 2018, physicians in all public long-term nursing homes in Bergen, Norway, scored residents according to the original Flacker Kiely index. Mortality data were derived from the Norwegian Cause of Death Registry and NT-ProBNP values were obtained from routinely collected blood chemistry. An alternative FK index using the NT-ProBNP-value as a marker for the presence of heart failure was constructed (FK NT-ProBNP index). The ProBNP cut-off value was selected based on a Cox regression model (“dead/alive 1 year”/” NT-ProBNP (Ng/l)”, where the value with the highest Youden index was identified. We judged index performance by using c-statistics.Results: Both the original FK index and the constructed FK NT-ProBNP index discriminated between risk strata. The FK NT-ProBNP index yielded a C-index of 0.66 compared to 0.62 for the original FK index. Optimal discriminatory power was shown with a NT-ProBNP cut-off value of 1,595 Ng/l as heart failure criterion, and FK NT-ProBNP score 6.6.Conclusions: The prospective mortality estimation ability of the FK-index was comparable to previous retrospective studies. The inclusion of NT-ProBNP as a heart failure criterion strengthen the discriminatory power and utility of the index, both in clinic and administration.
机译：目的：建立了几项死亡率指标，以帮助老年人的临床决策。我们旨在展示挪威护理家庭队列中的推翻（FK）死亡率指数，尚未完成，并探索NT-Probnp是否可以改善其歧视性。方法：我们进行了队列/死亡率研究。从2017年11月到2018年7月，所有公共长期护理住宅的医生，挪威的卑尔根，根据原有的闪碎机的居民获得居民。死亡数据来自死亡登记处的挪威原因，并且从常规收集的血液化学获得了NT-ProbNP值。构建了使用NT-probnp-ange作为存在心力衰竭的标记的替代FK索引（FK NT-ProbnP指数）。基于Cox回归模型（“死/活式1年”/“NT-Probnp（NG / L）”选择了ProbnP截止值，其中确定了最高索引指数的值。我们判断索引性能使用C-statistics.results：原始FK索引和风险地层之间的构造FK-probnp索引均有区间歧视。FK NT-Probnp指数产生0.66的C折射率，而原始FK指数为0.62。最佳歧视力被显示出具有1,595 ng / l作为心力衰竭标准的NT-probnp截止值，以及FK NT-probnp得分6.6。结论：FK指数的前瞻性死亡率估计能力与先前的回顾性研究相当。纳入NT-ProBNP作为心力衰竭标准，增强了临床和管理中指数的歧视力和效用。

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