目的:该研究旨在通过对疾病的严重程度进行分类并确定影响哥伦比亚两个高度复杂的成人重症监护病房的变量来表征重症监护综合征。
方法:描述性,横截面,在135名患者的样本中,使用健康衰老脑监护仪进行了前瞻性研究,以表征危重疾病的幸存者。使用高斯混合模型对重症监护后综合征的严重程度进行分类,通过序数逻辑回归确定影响最大的变量。
结果:基于高斯混合模型的聚类可以将重症监护综合征的严重程度分为轻度,中度,和严重的班级,Akaike信息准则为308,曲线下面积为0.80,这表明拟合良好;因此,轻度类别的特征在于HABC-M总分评分≤9;中度类别为HABC-M总分≥10且≤42,重度类别为HABC-M总分≥43.关于影响最大的变量,属于中度或重度类别的可能性与男性有关(91%),APACHEII评分(22.5%),年龄(13%),重症监护病房住院天数(10.6%),使用镇静剂,镇痛和神经肌肉阻滞剂。
结论:使用健康老化脑监护量表对重症监护病房幸存者进行了表征,这使得通过高斯混合模型聚类将重症监护综合征分类为轻度,中度,并确定对重症监护后综合征的表现有主要影响的变量。
OBJECTIVE: The study aims to characterise Postintensive Care Syndrome by classifying the severity of the disease and identifying the variables of influence in two highly complex intensive care units for adults in Colombia.
METHODS: A descriptive, cross-sectional, prospective study was carried out to characterise survivors of critical illness using the Healthy Aging Brain Care -Monitor in a sample of 135 patients. Postintensive Care Syndrome severity was classified using Gaussian Mixture Models for clustering, and the most influencing variables were identified through ordinal logistic regression.
RESULTS: Clustering based on Gaussian Mixture Models allowed the classification of Postintensive Care Syndrome severity into mild, moderate, and severe classes, with an Akaike Information Criterion of 308 and an area under the curve of 0.80, which indicates a good fit; Thus, the mild class was characterised by a score on the HABC-M Total scale ≤9; the moderate class for a HABC-M Total score ≥10 and ≤42 and the severe class for a HABC-M Total score ≥43. Regarding the most influencing variables, the probability of belonging to the moderate or severe classes was related to male sex (91%), APACHE II score (22.5%), age (13%), intensive care units days of stay (10.6%), the use of sedation, analgesia and neuromuscular blockers.
CONCLUSIONS: Intensive care units survivors were characterised using the Healthy Aging Brain Care-Monitor scale, which made it possible to classify Postintensive Care Syndrome through Gaussian Mixture Models clustering into mild, moderate, and severe and to identify variables that had the major influence on the presentation of Postintensive Care Syndrome.