Article(id=1322925087749448664, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924976893993108, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.16.023, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1758729600000, receivedDateStr=2025-09-25, revisedDate=1784995200000, revisedDateStr=2026-07-26, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339519678, onlineDateStr=2026-10-30, pubDate=1787587200000, pubDateStr=2026-08-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339519678, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339519678, creator=13701087609, updateTime=1793339519678, updator=13701087609, issue=Issue{id=1322924976893993108, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='16', pageStart='2769', pageEnd='2960', issueExtLink='null', onlineDate='null', pubDate='1787587200000', pubDateStr='2026-08-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793339493249, creator='13701087609', updateTime=1793343103544, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940119640047671, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924976893993108, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940119640047672, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924976893993108, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2925, endPage=2934, ext={EN=ArticleExt(id=1322925089024517084, articleId=1322925087749448664, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Risk predictive models of unplanned discontinuation of continuous renal replacement therapy in ICU patients:a scoping review, columnId=1220689485315101342, journalTitle=Chinese Nursing Research, columnName=Review Articles, runingTitle=null, highlight=null, articleAbstract=
Objective

To review the risk prediction models of unplanned discontinuation of continuous renal replacement therapy(CRRT) in ICU patients,and to provide evidence-based guidance for healthcare providers in selecting or developing appropriate risk prediction models.

Methods

This study systematically retrieved relevant studies from Chinese and English databases such as OVID,CINAHL,PubMed,Web of Science,Cochrane Library,EMbase,CNKI,VIP,WanFang,and China Biomedical Literature Database.The search period was from the establishment of the databases to August 12, 2025.

Results

A total of 19 studies were included,involving 28 models.Sample sizes ranged from 79 to 2 531 cases.The area under curve(AUC) for the 28 models ranged from 0.705 to 0.978.Calibration methods were reported in 17 studies.The overall applicability of the 19 studies was good,but there was still a relatively high risk of bias,mainly concentrated in the field of data analysis.

Conclusions

The risk prediction models of unplanned discontinuation of CRRT in ICU patients are still in the development stage.Future research should further improve the quality of related model studies,especially in aspects such as the selection of predictive factors and model evaluation,so as to provide effective tools for clinical practitioners to formulate individualized intervention strategies.

, authors=Mengqian WANG, Xiumei LIU, Shanshan CONG, Yunyan JIA, Yan TANG, Yannan KANG, authorsList=Mengqian WANG, Xiumei LIU, Shanshan CONG, Yunyan JIA, Yan TANG, Yannan KANG, authorCompany=null, correspAuthors=Yannan KANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322925089745937373, articleId=1322925087749448664, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=ICU病人连续性肾脏替代治疗非计划下机风险预测模型的范围综述, columnId=1220689485482873504, journalTitle=护理研究, columnName=科研综述, runingTitle=null, highlight=null, articleAbstract=
目的

综述ICU病人连续性肾脏替代治疗(CRRT)非计划下机风险预测模型,为医护人员选择或开发合适的风险预测模型提供循证依据。

方法

系统检索OVID、CINAHL、PubMed、Web of Science、Cochrane Library、EMbase、中国知网、维普数据库、万方数据库、中国生物医学文献数据库等中英文数据库中的相关研究,检索时限为建库至2025年8月12日。

结果

共纳入19项研究,涉及28个模型,样本量为79~2 531例。28个模型的受试者工作特征曲线下面积为0.705~0.978,17项研究报告了模型校准方法。19项研究总体适用性较好,但仍存在较高的偏倚风险,主要集中在数据分析领域。

结论

ICU病人CRRT非计划下机风险预测模型尚处在发展阶段,未来应进一步提高相关模型研究的质量,尤其是在预测因子选择、模型评价等方面应更加规范,以期为临床制定个体化干预策略提供有效工具。

, authors=王梦倩, 刘秀梅, 丛珊珊, 贾云艳, 唐妍, 康艳楠*, *, authorsList=王梦倩, 刘秀梅, 丛珊珊, 贾云艳, 唐妍, 康艳楠, authorCompany=null, correspAuthors=康艳楠, authorNote=

王梦倩,硕士研究生

, correspAuthorsNote=
康艳楠,E-mail:
KANG Yannan, E-mail:
, copyrightStatement=除非特别声明,本刊刊出的所有文章不代表本刊编委会的观点。, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=2vsRh47c+qj4yYfkGP5/Mw==, magXml=ES4MIEKSVRrwPQMMww0yDw==, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=4l18hYQvYM0zC9wlWeIy1Q==, mapNumber=null, fund=null)}, authors=[Author(id=1322925090496717795, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1322925091255886821, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925090496717795, language=EN, stringName=Mengqian WANG, firstName=Mengqian, middleName=null, lastName=WANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1322925091692094438, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925090496717795, language=CN, stringName=王梦倩, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1大连医科大学附属第一医院,辽宁 116011, bio={"content":"

王梦倩,硕士研究生

"}, bioImg=null, bioContent=

王梦倩,硕士研究生

, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1322925090219893727, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, xref=1, ext=[AuthorCompanyExt(id=1322925090228282336, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China), AuthorCompanyExt(id=1322925090240865249, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1大连医科大学附属第一医院,辽宁 116011)])]), Author(id=1322925093390787560, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, orderNo=1, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1322925093831189482, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925093390787560, language=EN, stringName=Xiumei LIU, firstName=Xiumei, middleName=null, lastName=LIU, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1322925094233842668, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925093390787560, language=CN, stringName=刘秀梅, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1大连医科大学附属第一医院,辽宁 116011, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1322925090219893727, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, xref=1, ext=[AuthorCompanyExt(id=1322925090228282336, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China), AuthorCompanyExt(id=1322925090240865249, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1大连医科大学附属第一医院,辽宁 116011)])]), Author(id=1322925095026566126, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, orderNo=2, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1322925095458579440, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925095026566126, language=EN, stringName=Shanshan CONG, firstName=Shanshan, middleName=null, lastName=CONG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1322925095924147185, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925095026566126, language=CN, stringName=丛珊珊, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1大连医科大学附属第一医院,辽宁 116011, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1322925090219893727, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, xref=1, ext=[AuthorCompanyExt(id=1322925090228282336, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China), AuthorCompanyExt(id=1322925090240865249, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1大连医科大学附属第一医院,辽宁 116011)])]), Author(id=1322925096037393395, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, orderNo=3, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1322925097731892215, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925096037393395, language=EN, stringName=Yunyan JIA, firstName=Yunyan, middleName=null, lastName=JIA, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1322925097832555512, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925096037393395, language=CN, stringName=贾云艳, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1大连医科大学附属第一医院,辽宁 116011, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1322925090219893727, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, xref=1, ext=[AuthorCompanyExt(id=1322925090228282336, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China), AuthorCompanyExt(id=1322925090240865249, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1大连医科大学附属第一医院,辽宁 116011)])]), Author(id=1322925097924830202, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, orderNo=4, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1322925098000327676, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925097924830202, language=EN, stringName=Yan TANG, firstName=Yan, middleName=null, lastName=TANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1322925098067436541, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925097924830202, language=CN, stringName=唐妍, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1大连医科大学附属第一医院,辽宁 116011, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1322925090219893727, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, xref=1, ext=[AuthorCompanyExt(id=1322925090228282336, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China), AuthorCompanyExt(id=1322925090240865249, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1大连医科大学附属第一医院,辽宁 116011)])]), Author(id=1322925098134545407, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, orderNo=5, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=15165067126@163.com, emailSecond=null, emailThird=null, correspondingAuthor=1, authorType=1, ext={EN=AuthorExt(id=1322925098214236160, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925098134545407, language=EN, stringName=Yannan KANG, firstName=Yannan, middleName=null, lastName=KANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1322925098277150721, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925098134545407, language=CN, stringName=康艳楠, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=*, *, address=1大连医科大学附属第一医院,辽宁 116011, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1322925090219893727, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, xref=1, ext=[AuthorCompanyExt(id=1322925090228282336, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China), AuthorCompanyExt(id=1322925090240865249, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1大连医科大学附属第一医院,辽宁 116011)])])], keywords=[Keyword(id=1322925098444922882, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=EN, orderNo=1, keyword=intensive care unit,ICU), Keyword(id=1322925098507837443, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=EN, orderNo=2, keyword=continuous renal replacement therapy), Keyword(id=1322925098583334916, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=EN, orderNo=3, keyword=unplanned disconnection), Keyword(id=1322925098847576069, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=EN, orderNo=4, keyword=prediction model), Keyword(id=1322925098931462150, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=EN, orderNo=5, keyword=scoping review), Keyword(id=1322925099011153927, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=EN, orderNo=6, keyword=evidence-based nursing), Keyword(id=1322925099099234312, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=CN, orderNo=1, keyword=重症监护室), Keyword(id=1322925099237646346, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=CN, orderNo=2, keyword=连续性肾脏替代治疗), Keyword(id=1322925099334115339, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=CN, orderNo=3, keyword=非计划下机), Keyword(id=1322925099413807116, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=CN, orderNo=4, keyword=预测模型), Keyword(id=1322925099531247629, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=CN, orderNo=5, keyword=范围综述), Keyword(id=1322925099661271054, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=CN, orderNo=6, keyword=循证护理)], refs=[Reference(id=1322925102693752858, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2025, volume=15, issue=7, pageStart=3267, pageEnd=3285, url=null, language=null, rfNumber=1, rfOrder=0, authorNames=Luo T G, Lin F, Huang H C, journalName=American Journal of Cancer Research, refType=null, unstructuredReference=Luo T G,Lin F,Huang H C.Clinical impact and safety of continuous renal replacement therapy in critically ill patients with solid tumors and acute kidney injury:a retrospective cohort analysis[J].American Journal of Cancer Research,2025,15(7):3267-3285., articleTitle=Clinical impact and safety of continuous renal replacement therapy in critically ill patients with solid tumors and acute kidney injury:a retrospective cohort analysis, refAbstract=null), Reference(id=1322925102999937051, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=10.3390/healthcare13182320, pmid=null, pmcid=null, year=2025, volume=13, issue=18, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=2, rfOrder=1, authorNames=Alkubati S A, Alfaraaj A A, Almoliky M A, journalName=Healthcare, refType=null, unstructuredReference=Alkubati S A,Alfaraaj A A,Almoliky M A,et al.Exploring the readiness of critical care in implementing continuous renal replacement therapy in hail hospitals,Saudi Arabia:findings for acute kidney injury patient care improvement[J].Healthcare,2025,13(18)., articleTitle=Exploring the readiness of critical care in implementing continuous renal replacement therapy in hail hospitals,Saudi Arabia:findings for acute kidney injury patient care improvement, refAbstract=null), Reference(id=1322925103062851612, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2021, volume=null, issue=null, pageStart=1, pageEnd=null, url=null, language=null, rfNumber=3, rfOrder=2, authorNames=陈香美, journalName=血液净化标准操作规程, refType=null, unstructuredReference=陈香美.血液净化标准操作规程[M].北京:人民卫生出版社,2021:1., articleTitle=null, refAbstract=null), Reference(id=1322925103142543389, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2025, volume=29, issue=1, pageStart=287, pageEnd=null, url=null, language=null, rfNumber=4, rfOrder=3, authorNames=Raina R, Kashani K, Sethi S K, journalName=Critical Care, refType=null, unstructuredReference=Raina R,Kashani K,Sethi S K,et al.Liberation from continuous renal replacement therapy due to renal recovery in adults and children:a literature review and Delphi consensus on clinical practice[J].Critical Care,2025,29(1):287., articleTitle=Liberation from continuous renal replacement therapy due to renal recovery in adults and children:a literature review and Delphi consensus on clinical practice, refAbstract=null), Reference(id=1322925103423561758, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2024, volume=46, issue=2, pageStart=2387431, pageEnd=null, url=null, language=null, rfNumber=5, rfOrder=4, authorNames=Zeng Z, Shen Y Q, Wan L, journalName=Renal Failure, refType=null, unstructuredReference=Zeng Z,Shen Y Q,Wan L,et al.Risk factors for unplanned weaning of continuous renal replacement therapy in ICU patients:a meta-analysis[J].Renal Failure,2024,46(2):2387431., articleTitle=Risk factors for unplanned weaning of continuous renal replacement therapy in ICU patients:a meta-analysis, refAbstract=null), Reference(id=1322925103507447839, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2010, volume=30, issue=2, pageStart=79, pageEnd=83, url=null, language=null, rfNumber=6, rfOrder=5, authorNames=Kim I B, Fealy N, Baldwin I, journalName=Blood Purification, refType=null, unstructuredReference=Kim I B,Fealy N,Baldwin I,et al.Premature circuit clotting due to likely mechanical failure during continuous renal replacement therapy[J].Blood Purification,2010,30(2):79-83., articleTitle=Premature circuit clotting due to likely mechanical failure during continuous renal replacement therapy, refAbstract=null), Reference(id=1322925103582945312, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2018, volume=32, issue=18, pageStart=2926, pageEnd=2930, url=null, language=null, rfNumber=7, rfOrder=6, authorNames=查丽玲, 周松, 江榕, journalName=护理研究, refType=null, unstructuredReference=查丽玲,周松,江榕.ICU行枸橼酸抗凝CRRT病人非计划性下机影响因素研究[J].护理研究,2018,32(18):2926-2930., articleTitle=ICU行枸橼酸抗凝CRRT病人非计划性下机影响因素研究, refAbstract=null), Reference(id=1322925103859769377, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2020, volume=324, issue=16, pageStart=1629, pageEnd=1639, url=null, language=null, rfNumber=8, rfOrder=7, authorNames=Zarbock A, Küllmar M, Kindgen-Milles D, journalName=JAMA, refType=null, unstructuredReference=Zarbock A,Küllmar M,Kindgen-Milles D,et al.Effect of regional citrate anticoagulation vs systemic heparin anticoagulation during continuous kidney replacement therapy on dialysis filter life span and mortality among critically ill patients with acute kidney injury:a randomized clinical trial[J].JAMA,2020,324(16):1629-1639., articleTitle=Effect of regional citrate anticoagulation vs systemic heparin anticoagulation during continuous kidney replacement therapy on dialysis filter life span and mortality among critically ill patients with acute kidney injury:a randomized clinical trial, refAbstract=null), Reference(id=1322925104304365602, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2020, volume=3, issue=1, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=9, rfOrder=8, authorNames=Tsujimoto H, Tsujimoto Y, Nakata Y, journalName=Cochrane Database of Systematic Reviews, refType=null, unstructuredReference=Tsujimoto H,Tsujimoto Y,Nakata Y,et al.Pharmacological interventions for preventing clotting of extracorporeal circuits during continuous renal replacement therapy[J].Cochrane Database of Systematic Reviews,2020,3(1):CD012467., articleTitle=Pharmacological interventions for preventing clotting of extracorporeal circuits during continuous renal replacement therapy, refAbstract=null), Reference(id=1322925104715407396, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2017, volume=18, issue=1, pageStart=69, pageEnd=null, url=null, language=null, rfNumber=10, rfOrder=9, authorNames=Brain M, Winson E, Roodenburg O, journalName=BMC Nephrology, refType=null, unstructuredReference=Brain M,Winson E,Roodenburg O,et al.Non anti-coagulant factors associated with filter life in continuous renal replacement therapy(CRRT):a systematic review and meta-analysis[J].BMC Nephrology,2017,18(1):69., articleTitle=Non anti-coagulant factors associated with filter life in continuous renal replacement therapy(CRRT):a systematic review and meta-analysis, refAbstract=null), Reference(id=1322925105122254885, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2024, volume=52, issue=8, pageStart=1294, pageEnd=1298, url=null, language=null, rfNumber=11, rfOrder=10, authorNames=彭莉, 赵振华, 蔡雪, journalName=现代医学, refType=null, unstructuredReference=彭莉,赵振华,蔡雪,等.ICU患者RCA-CRRT非计划下机影响因素的研究进展[J].现代医学,2024,52(8):1294-1298., articleTitle=ICU患者RCA-CRRT非计划下机影响因素的研究进展, refAbstract=null), Reference(id=1322925106783199270, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2016, volume=42, issue=3, pageStart=266, pageEnd=278, url=null, language=null, rfNumber=12, rfOrder=11, authorNames=Murugan R, Hoste E, Mehta R L, journalName=Blood Purification, refType=null, unstructuredReference=Murugan R,Hoste E,Mehta R L,et al.Precision fluid management in continuous renal replacement therapy[J].Blood Purification,2016,42(3):266-278., articleTitle=Precision fluid management in continuous renal replacement therapy, refAbstract=null), Reference(id=1322925106858696744, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2022, volume=51, issue=6, pageStart=523, pageEnd=530, url=null, language=null, rfNumber=13, rfOrder=12, authorNames=Foglia M J, Pelletier J H, Bayir H, journalName=Blood Purification, refType=null, unstructuredReference=Foglia M J,Pelletier J H,Bayir H,et al.Tandem therapeutic plasma exchange reduces continuous renal replacement therapy downtime[J].Blood Purification,2022,51(6):523-530., articleTitle=Tandem therapeutic plasma exchange reduces continuous renal replacement therapy downtime, refAbstract=null), Reference(id=1322925106950971433, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2016, volume=42, issue=3, pageStart=221, pageEnd=223, url=null, language=null, rfNumber=14, rfOrder=13, authorNames=Kellum J A, Ronco C, journalName=Blood Purification, refType=null, unstructuredReference=Kellum J A,Ronco C.The 17th acute disease quality initiative international consensus conference:introducing precision renal replacement therapy[J].Blood Purification,2016,42(3):221-223., articleTitle=The 17th acute disease quality initiative international consensus conference:introducing precision renal replacement therapy, refAbstract=null), Reference(id=1322925107257155626, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2014, volume=11, issue=10, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=15, rfOrder=14, authorNames=Moons K G M, de Groot J A H, Bouwmeester W, journalName=PLoS Medicine, refType=null, unstructuredReference=Moons K G M,de Groot J A H,Bouwmeester W,et al.Critical appraisal and data extraction for systematic reviews of prediction modelling studies:the CHARMS checklist[J].PLoS Medicine,2014,11(10):e1001744., articleTitle=Critical appraisal and data extraction for systematic reviews of prediction modelling studies:the CHARMS checklist, refAbstract=null), Reference(id=1322925107345236011, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2019, volume=170, issue=1, pageStart=W1, pageEnd=W33, url=null, language=null, rfNumber=16, rfOrder=15, authorNames=Moons K G M, Wolff R F, Riley R D, journalName=Annals of Internal Medicine, refType=null, unstructuredReference=Moons K G M,Wolff R F,Riley R D,et al.PROBAST:a tool to assess risk of bias and applicability of prediction model studies:explanation and elaboration[J].Annals of Internal Medicine,2019,170(1):W1-W33., articleTitle=PROBAST:a tool to assess risk of bias and applicability of prediction model studies:explanation and elaboration, refAbstract=null), Reference(id=1322925107622060076, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2025, volume=33, issue=5, pageStart=2305, pageEnd=2319, url=null, language=null, rfNumber=17, rfOrder=16, authorNames=Wang F Z, Zhang R, Tan L, journalName=Technology and Health Care, refType=null, unstructuredReference=Wang F Z,Zhang R,Tan L,et al.A predictive model for real-time LSTM methods:monitoring dynamic transmembrane pressure improves loop life and anticoagulant therapy accuracy in continuous renal replacement therapy[J].Technology and Health Care,2025,33(5):2305-2319., articleTitle=A predictive model for real-time LSTM methods:monitoring dynamic transmembrane pressure improves loop life and anticoagulant therapy accuracy in continuous renal replacement therapy, refAbstract=null), Reference(id=1322925107701751855, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2025, volume=45, issue=7, pageStart=619, pageEnd=624, url=null, language=null, rfNumber=18, rfOrder=17, authorNames=何淑雅, 丁玲玲, journalName=中国急救医学, refType=null, unstructuredReference=何淑雅,丁玲玲.老年急性心力衰竭患者连续性肾脏替代治疗非计划性下机的影响因素及预测模型构建[J].中国急救医学,2025,45(7):619-624., articleTitle=老年急性心力衰竭患者连续性肾脏替代治疗非计划性下机的影响因素及预测模型构建, refAbstract=null), Reference(id=1322925108091822128, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2025, volume=24, issue=4, pageStart=278, pageEnd=282, url=null, language=null, rfNumber=19, rfOrder=18, authorNames=刘倩, 张明, 孙邵婷, journalName=中国血液净化, refType=null, unstructuredReference=刘倩,张明,孙邵婷,等.构建评估连续性肾脏替代治疗抗凝失败风险的列线图模型[J].中国血液净化,2025,24(4):278-282., articleTitle=构建评估连续性肾脏替代治疗抗凝失败风险的列线图模型, refAbstract=null), Reference(id=1322925108469309489, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2025, volume=24, issue=1, pageStart=13, pageEnd=17, url=null, language=null, rfNumber=20, rfOrder=19, authorNames=全梓林, 尹燕, 崔冬梅, journalName=中国血液净化, refType=null, unstructuredReference=全梓林,尹燕,崔冬梅,等.基于列线图构建儿童连续性肾脏替代治疗体外循环衰竭预测模型[J].中国血液净化,2025,24(1):13-17., articleTitle=基于列线图构建儿童连续性肾脏替代治疗体外循环衰竭预测模型, refAbstract=null), Reference(id=1322925108540612658, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2025, volume=14, issue=3, pageStart=16, pageEnd=21, url=null, language=null, rfNumber=21, rfOrder=20, authorNames=李林莉, 杨家慧, journalName=转化医学杂志, refType=null, unstructuredReference=李林莉,杨家慧.重症胰腺炎CRRT治疗患者发生非计划性下机预测模型的建构[J].转化医学杂志,2025,14(3):16-21., articleTitle=重症胰腺炎CRRT治疗患者发生非计划性下机预测模型的建构, refAbstract=null), Reference(id=1322925108871962675, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2025, volume=11, issue=2, pageStart=157, pageEnd=160, url=null, language=null, rfNumber=22, rfOrder=21, authorNames=蒋丽丽, 於环环, 陶镜羽, journalName=中西医结合护理(中英文), refType=null, unstructuredReference=蒋丽丽,於环环,陶镜羽,等.连续性肾脏替代治疗非计划性下机的影响因素研究及预测模型构建[J].中西医结合护理(中英文),2025,11(2):157-160., articleTitle=连续性肾脏替代治疗非计划性下机的影响因素研究及预测模型构建, refAbstract=null), Reference(id=1322925108943265844, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2025, volume=63, issue=1, pageStart=38, pageEnd=42, url=null, language=null, rfNumber=23, rfOrder=22, authorNames=孙媛, 顾云雨, 黄燕, journalName=中国现代医生, refType=null, unstructuredReference=孙媛,顾云雨,黄燕.尿毒症患者应用CRRT时体外循环装置凝血的危险因素及预警模型[J].中国现代医生,2025,63(1):38-42., articleTitle=尿毒症患者应用CRRT时体外循环装置凝血的危险因素及预警模型, refAbstract=null), Reference(id=1322925109010374709, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2025, volume=30, issue=4, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=24, rfOrder=23, authorNames=Chen Z B, Pan L G, Zhang J, journalName=Nursing in Critical Care, refType=null, unstructuredReference=Chen Z B,Pan L G,Zhang J,et al.Development and validation of a nomogram for circuit lifespan of regional citrate anticoagulation-continuous renal replacement therapy in intensive care patients with acute kidney injury[J].Nursing in Critical Care,2025,30(4):e13196., articleTitle=Development and validation of a nomogram for circuit lifespan of regional citrate anticoagulation-continuous renal replacement therapy in intensive care patients with acute kidney injury, refAbstract=null), Reference(id=1322925109312364598, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2024, volume=10, issue=25, pageStart=68, pageEnd=72, url=null, language=null, rfNumber=25, rfOrder=24, authorNames=贾燕, 李娜, 刘考, journalName=智慧健康, refType=null, unstructuredReference=贾燕,李娜,刘考,等.连续性肾脏替代治疗滤器凝血风险预测模型的构建及验证[J].智慧健康,2024,10(25):68-72., articleTitle=连续性肾脏替代治疗滤器凝血风险预测模型的构建及验证, refAbstract=null), Reference(id=1322925109417222199, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2024, volume=84, issue=null, pageStart=103703, pageEnd=null, url=null, language=null, rfNumber=26, rfOrder=25, authorNames=Yang E M, Wang Q H, Guo J, journalName=Intensive & Critical Care Nursing, refType=null, unstructuredReference=Yang E M,Wang Q H,Guo J,et al.Development and external validation of a prediction model for the premature circuit clotting of continuous renal replacement therapy in critically ill patients[J].Intensive & Critical Care Nursing,2024,84:103703., articleTitle=Development and external validation of a prediction model for the premature circuit clotting of continuous renal replacement therapy in critically ill patients, refAbstract=null), Reference(id=1322925111174635576, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2024, volume=36, issue=5, pageStart=520, pageEnd=526, url=null, language=null, rfNumber=27, rfOrder=26, authorNames=许红妍, 任奇, 祝利红, journalName=中华危重病急救医学, refType=null, unstructuredReference=许红妍,任奇,祝利红,等.连续性肾脏替代治疗非计划下机风险预测模型的构建与外部验证[J].中华危重病急救医学,2024,36(5):520-526., articleTitle=连续性肾脏替代治疗非计划下机风险预测模型的构建与外部验证, refAbstract=null), Reference(id=1322925111396933689, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2024, volume=53, issue=11/12, pageStart=916, pageEnd=927, url=null, language=null, rfNumber=28, rfOrder=27, authorNames=Liu L, Liu D S, He T, journalName=Blood Purification, refType=null, unstructuredReference=Liu L,Liu D S,He T,et al.Coagulation risk predicting in anticoagulant-free continuous renal replacement therapy[J].Blood Purification,2024,53(11/12):916-927., articleTitle=Coagulation risk predicting in anticoagulant-free continuous renal replacement therapy, refAbstract=null), Reference(id=1322925111472431162, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2023, volume=58, issue=15, pageStart=1845, pageEnd=1851, url=null, language=null, rfNumber=29, rfOrder=28, authorNames=胡璐璐, 牛洪艳, 韩小云, journalName=中华护理杂志, refType=null, unstructuredReference=胡璐璐,牛洪艳,韩小云,等.连续性肾脏替代治疗体外循环装置凝血风险预测模型的构建与验证[J].中华护理杂志,2023,58(15):1845-1851., articleTitle=连续性肾脏替代治疗体外循环装置凝血风险预测模型的构建与验证, refAbstract=null), Reference(id=1322925111828947003, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2023, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=30, rfOrder=29, authorNames=吴玲玲, journalName=null, refType=null, unstructuredReference=吴玲玲.脓毒症患者血液净化非计划性下机影响因素分析及风险预测模型构建[D].遵义:遵义医科大学,2023., articleTitle=脓毒症患者血液净化非计划性下机影响因素分析及风险预测模型构建, refAbstract=null), Reference(id=1322925111900250172, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2022, volume=37, issue=12, pageStart=6, pageEnd=9, url=null, language=null, rfNumber=31, rfOrder=30, authorNames=万娜, 于洋, 王淑芹, journalName=护理学杂志, refType=null, unstructuredReference=万娜,于洋,王淑芹,等.ECMO联合应用期间CRRT非计划性下机的预测模型构建[J].护理学杂志,2022,37(12):6-9., articleTitle=ECMO联合应用期间CRRT非计划性下机的预测模型构建, refAbstract=null), Reference(id=1322925112231600189, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2022, volume=22, issue=12, pageStart=1016, pageEnd=1022, url=null, language=null, rfNumber=32, rfOrder=31, authorNames=常蓉, 李玲玲, journalName=临床肾脏病杂志, refType=null, unstructuredReference=常蓉,李玲玲.连续性肾脏替代治疗患者发生管路凝血预测模型的构建[J].临床肾脏病杂志,2022,22(12):1016-1022., articleTitle=连续性肾脏替代治疗患者发生管路凝血预测模型的构建, refAbstract=null), Reference(id=1322925112294514750, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2022, volume=51, issue=8, pageStart=668, pageEnd=678, url=null, language=null, rfNumber=33, rfOrder=32, authorNames=Zhang W, Bai M, Zhang L, journalName=Blood Purification, refType=null, unstructuredReference=Zhang W,Bai M,Zhang L,et al.Development and external validation of a model for predicting sufficient filter lifespan in anticoagulation-free continuous renal replacement therapy patients[J].Blood Purification,2022,51(8):668-678., articleTitle=Development and external validation of a model for predicting sufficient filter lifespan in anticoagulation-free continuous renal replacement therapy patients, refAbstract=null), Reference(id=1322925112357429311, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2017, volume=32, issue=7, pageStart=1251, pageEnd=1261, url=null, language=null, rfNumber=34, rfOrder=33, authorNames=Kakajiwala A, Jemielita T, Hughes J Z, journalName=Pediatric Nephrology, refType=null, unstructuredReference=Kakajiwala A,Jemielita T,Hughes J Z,et al.Membrane pressures predict clotting of pediatric continuous renal replacement therapy circuits[J].Pediatric Nephrology,2017,32(7):1251-1261., articleTitle=Membrane pressures predict clotting of pediatric continuous renal replacement therapy circuits, refAbstract=null), Reference(id=1322925112688779328, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2014, volume=46, issue=4, pageStart=801, pageEnd=807, url=null, language=null, rfNumber=35, rfOrder=34, authorNames=Fu X, Liang X L, Song L, journalName=International Urology and Nephrology, refType=null, unstructuredReference=Fu X,Liang X L,Song L,et al.Building and validation of a prognostic model for predicting extracorporeal circuit clotting in patients with continuous renal replacement therapy[J].International Urology and Nephrology,2014,46(4):801-807., articleTitle=Building and validation of a prognostic model for predicting extracorporeal circuit clotting in patients with continuous renal replacement therapy, refAbstract=null), Reference(id=1322925112793636929, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2020, volume=20, issue=6, pageStart=737, pageEnd=744, url=null, language=null, rfNumber=36, rfOrder=35, authorNames=陈香萍, 张奕, 庄一渝, journalName=中国循证医学杂志, refType=null, unstructuredReference=陈香萍,张奕,庄一渝,等.PROBAST:诊断或预后多因素预测模型研究偏倚风险的评估工具[J].中国循证医学杂志,2020,20(6):737-744., articleTitle=PROBAST:诊断或预后多因素预测模型研究偏倚风险的评估工具, refAbstract=null), Reference(id=1322925113074655298, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2025, volume=12, issue=1, pageStart=81, pageEnd=88, url=null, language=null, rfNumber=37, rfOrder=36, authorNames=Yang P F, Yang F, Wang Q, journalName=International Journal of Nursing Sciences, refType=null, unstructuredReference=Yang P F,Yang F,Wang Q,et al.Risk prediction models for post-intensive care syndrome of ICU discharged patients:a systematic review[J].International Journal of Nursing Sciences,2025,12(1):81-88., articleTitle=Risk prediction models for post-intensive care syndrome of ICU discharged patients:a systematic review, refAbstract=null), Reference(id=1322925113145958467, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2025, volume=32, issue=5, pageStart=677, pageEnd=684, url=null, language=null, rfNumber=38, rfOrder=37, authorNames=高瑞磊, 王丹, 戴国华, journalName=中国胸心血管外科临床杂志, refType=null, unstructuredReference=高瑞磊,王丹,戴国华,等.心力衰竭患者出院后再入院风险预测模型的系统评价[J].中国胸心血管外科临床杂志,2025,32(5):677-684., articleTitle=心力衰竭患者出院后再入院风险预测模型的系统评价, refAbstract=null), Reference(id=1322925113217261636, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2025, volume=60, issue=9, pageStart=1132, pageEnd=1139, url=null, language=null, rfNumber=39, rfOrder=38, authorNames=周淼, 陈星, 彭飞, journalName=中华护理杂志, refType=null, unstructuredReference=周淼,陈星,彭飞,等.ICU患者中心静脉导管相关血流感染风险预测工具的系统评价[J].中华护理杂志,2025,60(9):1132-1139., articleTitle=ICU患者中心静脉导管相关血流感染风险预测工具的系统评价, refAbstract=null), Reference(id=1322925113494085701, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2012, volume=98, issue=9, pageStart=683, pageEnd=690, url=null, language=null, rfNumber=40, rfOrder=39, authorNames=Moons K G, Kengne A P, Woodward M, journalName=Heart, refType=null, unstructuredReference=Moons K G,Kengne A P,Woodward M,et al.Risk prediction models:I.Development,internal validation,and assessing the incremental value of a new (bio)marker[J].Heart,2012,98(9):683-690., articleTitle=Risk prediction models:I.Development,internal validation,and assessing the incremental value of a new (bio)marker, refAbstract=null), Reference(id=1322925113573777478, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, doi=null, pmid=null, pmcid=null, year=2015, volume=42, issue=2, pageStart=135, pageEnd=147, url=null, language=null, rfNumber=41, rfOrder=40, authorNames=Przybyl H, Androwich I, Evans J, journalName=Nephrology Nursing Journal, refType=null, unstructuredReference=Przybyl H,Androwich I,Evans J.Using high-fidelity simulation to assess knowledge,skills,and attitudes in nurses performing CRRT[J].Nephrology Nursing Journal,2015,42(2):135-147., articleTitle=Using high-fidelity simulation to assess knowledge,skills,and attitudes in nurses performing CRRT, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1322925090219893727, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, xref=1, ext=[AuthorCompanyExt(id=1322925090228282336, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China), AuthorCompanyExt(id=1322925090240865249, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1大连医科大学附属第一医院,辽宁 116011)])], figs=[ArticleFig(id=1322925099803877391, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=EN, label=Table 1, caption=

Basic characteristics of the included literature(n=19)

, figureFileSmall=null, figureFileBig=null, tableContent=
作者发表
年份
国家研究类型研究对象结局定义结局事件
发生率(%)
Wang等[17]2025年中国回顾性队列研究接受连续性肾脏替代治疗的急性肾损伤ICU病人连续性肾脏替代治疗因凝血导致治疗中断11.90
何淑雅等[18]2025年中国前瞻性队列研究接受连续性肾脏替代治疗的急性心力衰竭ICU病人连续性肾脏替代治疗非计划下机22.58
刘倩等[19]2025年中国回顾性队列研究接受连续性肾脏替代治疗的成年ICU病人连续性肾脏替代治疗因凝血导致治疗中断29.76
全梓林等[20]2025年中国回顾性队列研究接受连续性肾脏替代治疗的儿童ICU病人连续性肾脏替代治疗因凝血导致治疗中断58.90
李林莉等[21]2025年中国回顾性队列研究接受连续性肾脏替代治疗的胰腺炎ICU病人连续性肾脏替代治疗非计划下机37.65
蒋丽丽等[22]2025年中国回顾性队列研究接受连续性肾脏替代治疗的成年ICU病人连续性肾脏替代治疗非计划下机8.46
孙媛等[23]2025年中国回顾性队列研究接受连续性肾脏替代治疗的尿毒症ICU病人连续性肾脏替代治疗非计划下机25.24
Chen等[24]2025年中国前瞻性队列研究接受连续性肾脏替代治疗的急性肾损伤ICU病人连续性肾脏替代治疗因凝血导致治疗中断23.76
贾燕等[25]2024年中国回顾性队列研究接受连续性肾脏替代治疗的成年ICU病人连续性肾脏替代治疗因凝血导致治疗中断19.46
Yang等[26]2024年中国回顾性队列研究接受连续性肾脏替代治疗的成年ICU病人连续性肾脏替代治疗因凝血导致治疗中断31.85
许红妍等[27]2024年中国回顾性队列研究接受连续性肾脏替代治疗的成年ICU病人连续性肾脏替代治疗非计划下机28.10
Liu等[28]2024年中国回顾性队列研究接受无抗凝剂连续性肾脏替代治疗的ICU病人连续性肾脏替代治疗因凝血导致治疗中断41.51
胡璐璐等[29]2023年中国回顾性队列研究接受连续性肾脏替代治疗的成年ICU病人连续性肾脏替代治疗因凝血导致治疗中断30.60
吴玲玲[30]2023年中国回顾性队列研究接受连续性肾脏替代治疗的成年ICU病人连续性肾脏替代治疗非计划下机59.66
万娜等[31]2022年中国回顾性队列研究接受体外膜肺氧合(ECMO)联合连续性肾脏替代治疗的ICU病人连续性肾脏替代治疗非计划下机61.80
常蓉等[32]2022年中国回顾性队列研究接受连续性肾脏替代治疗的成年ICU病人连续性肾脏替代治疗非计划下机17.90
Zhang等[33]2022年中国回顾性队列研究接受无抗凝连续性肾脏替代治疗的ICU病人连续性肾脏替代治疗因凝血导致治疗中断47.00
Kakajiwala等[34]2017年美国回顾性队列研究接受连续性肾脏替代治疗的ICU儿童病人连续性肾脏替代治疗非计划下机64.60
Fu等[35]2014年中国前瞻性队列研究接受连续性肾脏替代治疗的成年ICU病人连续性肾脏替代治疗因凝血导致治疗中断66.60
), ArticleFig(id=1322925099896152080, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=CN, label=表1, caption=

纳入文献研究的基本特征(n=19)

, figureFileSmall=null, figureFileBig=null, tableContent=
作者发表
年份
国家研究类型研究对象结局定义结局事件
发生率(%)
Wang等[17]2025年中国回顾性队列研究接受连续性肾脏替代治疗的急性肾损伤ICU病人连续性肾脏替代治疗因凝血导致治疗中断11.90
何淑雅等[18]2025年中国前瞻性队列研究接受连续性肾脏替代治疗的急性心力衰竭ICU病人连续性肾脏替代治疗非计划下机22.58
刘倩等[19]2025年中国回顾性队列研究接受连续性肾脏替代治疗的成年ICU病人连续性肾脏替代治疗因凝血导致治疗中断29.76
全梓林等[20]2025年中国回顾性队列研究接受连续性肾脏替代治疗的儿童ICU病人连续性肾脏替代治疗因凝血导致治疗中断58.90
李林莉等[21]2025年中国回顾性队列研究接受连续性肾脏替代治疗的胰腺炎ICU病人连续性肾脏替代治疗非计划下机37.65
蒋丽丽等[22]2025年中国回顾性队列研究接受连续性肾脏替代治疗的成年ICU病人连续性肾脏替代治疗非计划下机8.46
孙媛等[23]2025年中国回顾性队列研究接受连续性肾脏替代治疗的尿毒症ICU病人连续性肾脏替代治疗非计划下机25.24
Chen等[24]2025年中国前瞻性队列研究接受连续性肾脏替代治疗的急性肾损伤ICU病人连续性肾脏替代治疗因凝血导致治疗中断23.76
贾燕等[25]2024年中国回顾性队列研究接受连续性肾脏替代治疗的成年ICU病人连续性肾脏替代治疗因凝血导致治疗中断19.46
Yang等[26]2024年中国回顾性队列研究接受连续性肾脏替代治疗的成年ICU病人连续性肾脏替代治疗因凝血导致治疗中断31.85
许红妍等[27]2024年中国回顾性队列研究接受连续性肾脏替代治疗的成年ICU病人连续性肾脏替代治疗非计划下机28.10
Liu等[28]2024年中国回顾性队列研究接受无抗凝剂连续性肾脏替代治疗的ICU病人连续性肾脏替代治疗因凝血导致治疗中断41.51
胡璐璐等[29]2023年中国回顾性队列研究接受连续性肾脏替代治疗的成年ICU病人连续性肾脏替代治疗因凝血导致治疗中断30.60
吴玲玲[30]2023年中国回顾性队列研究接受连续性肾脏替代治疗的成年ICU病人连续性肾脏替代治疗非计划下机59.66
万娜等[31]2022年中国回顾性队列研究接受体外膜肺氧合(ECMO)联合连续性肾脏替代治疗的ICU病人连续性肾脏替代治疗非计划下机61.80
常蓉等[32]2022年中国回顾性队列研究接受连续性肾脏替代治疗的成年ICU病人连续性肾脏替代治疗非计划下机17.90
Zhang等[33]2022年中国回顾性队列研究接受无抗凝连续性肾脏替代治疗的ICU病人连续性肾脏替代治疗因凝血导致治疗中断47.00
Kakajiwala等[34]2017年美国回顾性队列研究接受连续性肾脏替代治疗的ICU儿童病人连续性肾脏替代治疗非计划下机64.60
Fu等[35]2014年中国前瞻性队列研究接受连续性肾脏替代治疗的成年ICU病人连续性肾脏替代治疗因凝血导致治疗中断66.60
), ArticleFig(id=1322925099988426769, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=EN, label=Table 2, caption=

Establishment of risk prediction model for unplanned disengagement of CRRT in ICU patients(n=19)

, figureFileSmall=null, figureFileBig=null, tableContent=
纳入文献模型构建预测变量
候选变量(个)连续变量
处理
缺失数据(个)缺失数据处理样本量
(例)
建模方法
Wang等[17]1卡尔曼滤波405长短期记忆神经网络(LSTM)跨膜压
何淑雅等[18]21原值输入217Logistic回归活化部分凝血活酶时间(APTT)、血细胞比容、导管功能、治疗剂量
刘倩等[19]21原值输入直接排除168Logistic回归血小板计数、APTT、血流速度、跨膜压、血细胞比容、血泵停泵
全梓林等[20]25原值输入370Logistic回归乳酸、血流量不足、超滤速度、体重
李林莉等[21]14原值输入85Logistic回归血流速度、血细胞比容、抗凝方式、机械通气、凝血酶原时间/活动度、导管功能
蒋丽丽等[22]12转为二分类变量直接排除532Logistic回归APTT、血流速度、机械通气、凝血酶原时间/活动度、输血/血制品、年龄
孙媛等[23]18原值输入300Logistic回归血小板计数、跨膜压、血流量不足、年龄、躁动
Chen等[24]24原值输入多重插补404COX比例风险回归
模型
乳酸、平均动脉压、输血/血制品、血红蛋白、序贯器官衰竭评估(SOFA)评分
贾燕等[25]10原值输入369Logistic回归血管活性药物使用、血流量不足、超滤速度
Yang等[26]48原值输入多重插补2 531Logistic回归跨膜压、血管活性药物使用、抗凝方式、体温、平均动脉压
许红妍等[27]12原值输入441Logistic回归血流速度、血泵停泵、导管功能、合并慢性病
Liu等[28]48原值输入11多重插补212Logistic回归、决策树、支持向量机、随机森林、极端梯度提升、梯度提升决策树、分类提升、集成学习血小板计数、滤过分数、三酰甘油
胡璐璐等[29]20原值输入直接排除480Logistic回归血小板计数、APTT、血泵停泵、抗凝方式、血流量不足、治疗模式
吴玲玲[30]32转为二分类变量多重插补295Logistic回归性别、体位、凝血酶原时间/活动度、纤维蛋白原、滤器类型
万娜等[31]15原值输入343Logistic回归血流速度、治疗模式、ECMO相关
常蓉等[32]15转为二分类变量484Logistic回归血小板计数血流速度、凝血酶原时间/活动度、治疗剂量、护士工作年限
Zhang等[33]37原值输入均值填补214Logistic回归血小板计数、APTT、血管活性药物使用、体温、平均动脉压、直接胆红素、碱性磷酸酶、血尿素氮、D-二聚体、pH值、白细胞计数、体重指数、尿酸
Kakajiwala等[34]102原值输入20~100时序样条插补79COX比例风险回归模型、Logistic回归、梯度提升机跨膜压、活化凝血时间、过滤器压力(FP)
Fu等[35]30转为二分类变量196直接排除425COX比例风险回归
模型
APTT、血细胞比容、抗凝方式、乳酸、血流量不足
), ArticleFig(id=1322925100072312850, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=CN, label=表2, caption=

ICU病人连续性肾脏替代治疗非计划下机风险预测模型的建立情况(n=19)

, figureFileSmall=null, figureFileBig=null, tableContent=
纳入文献模型构建预测变量
候选变量(个)连续变量
处理
缺失数据(个)缺失数据处理样本量
(例)
建模方法
Wang等[17]1卡尔曼滤波405长短期记忆神经网络(LSTM)跨膜压
何淑雅等[18]21原值输入217Logistic回归活化部分凝血活酶时间(APTT)、血细胞比容、导管功能、治疗剂量
刘倩等[19]21原值输入直接排除168Logistic回归血小板计数、APTT、血流速度、跨膜压、血细胞比容、血泵停泵
全梓林等[20]25原值输入370Logistic回归乳酸、血流量不足、超滤速度、体重
李林莉等[21]14原值输入85Logistic回归血流速度、血细胞比容、抗凝方式、机械通气、凝血酶原时间/活动度、导管功能
蒋丽丽等[22]12转为二分类变量直接排除532Logistic回归APTT、血流速度、机械通气、凝血酶原时间/活动度、输血/血制品、年龄
孙媛等[23]18原值输入300Logistic回归血小板计数、跨膜压、血流量不足、年龄、躁动
Chen等[24]24原值输入多重插补404COX比例风险回归
模型
乳酸、平均动脉压、输血/血制品、血红蛋白、序贯器官衰竭评估(SOFA)评分
贾燕等[25]10原值输入369Logistic回归血管活性药物使用、血流量不足、超滤速度
Yang等[26]48原值输入多重插补2 531Logistic回归跨膜压、血管活性药物使用、抗凝方式、体温、平均动脉压
许红妍等[27]12原值输入441Logistic回归血流速度、血泵停泵、导管功能、合并慢性病
Liu等[28]48原值输入11多重插补212Logistic回归、决策树、支持向量机、随机森林、极端梯度提升、梯度提升决策树、分类提升、集成学习血小板计数、滤过分数、三酰甘油
胡璐璐等[29]20原值输入直接排除480Logistic回归血小板计数、APTT、血泵停泵、抗凝方式、血流量不足、治疗模式
吴玲玲[30]32转为二分类变量多重插补295Logistic回归性别、体位、凝血酶原时间/活动度、纤维蛋白原、滤器类型
万娜等[31]15原值输入343Logistic回归血流速度、治疗模式、ECMO相关
常蓉等[32]15转为二分类变量484Logistic回归血小板计数血流速度、凝血酶原时间/活动度、治疗剂量、护士工作年限
Zhang等[33]37原值输入均值填补214Logistic回归血小板计数、APTT、血管活性药物使用、体温、平均动脉压、直接胆红素、碱性磷酸酶、血尿素氮、D-二聚体、pH值、白细胞计数、体重指数、尿酸
Kakajiwala等[34]102原值输入20~100时序样条插补79COX比例风险回归模型、Logistic回归、梯度提升机跨膜压、活化凝血时间、过滤器压力(FP)
Fu等[35]30转为二分类变量196直接排除425COX比例风险回归
模型
APTT、血细胞比容、抗凝方式、乳酸、血流量不足
), ArticleFig(id=1322925100172976147, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=EN, label=Table 3, caption=

Predictors that were repeated more than 3 times in CRRT unplanned off risk prediction model for ICU patients

, figureFileSmall=null, figureFileBig=null, tableContent=
预测因子次数(次)预测因子次数(次)
血小板计数6血管活性药物使用3
APTT6血泵停泵3
血流速度6乳酸3
跨膜压5平均动脉压3
血流量不足5年龄3
血细胞比容4导管功能3
抗凝方式4治疗模式3
凝血酶原时间/活动度4
), ArticleFig(id=1322925100265250836, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=CN, label=表3, caption=

ICU病人连续性肾脏替代治疗非计划下机风险预测模型中重复出现3次以上的预测因子

, figureFileSmall=null, figureFileBig=null, tableContent=
预测因子次数(次)预测因子次数(次)
血小板计数6血管活性药物使用3
APTT6血泵停泵3
血流速度6乳酸3
跨膜压5平均动脉压3
血流量不足5年龄3
血细胞比容4导管功能3
抗凝方式4治疗模式3
凝血酶原时间/活动度4
), ArticleFig(id=1322925100550463509, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=EN, label=Table 4, caption=

Performance of risk prediction model for unplanned disengagement of CRRT in ICU patients(n=19)

, figureFileSmall=null, figureFileBig=null, tableContent=
作者模型评价变量筛选方法校准方法模型验证模型呈现形式
内部验证外部验证(例)
Wang等[17]AUC=0.920,灵敏度=0.974,特异度=0.798全部纳入校准曲线滚动预测和在线学习算法框架
何淑雅等[18]AUC=0.936,灵敏度=0.800,特异度=1.000单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归校准曲线Bootstrap法
(1 000次抽样)
31列线图
刘倩等[19]AUC=0.978(0.958,0.997)LASSO回归H-L检验(P=0.939);校准曲线Bootstrap法
(1 000次抽样)
列线图
全梓林等[20]AUC=0.891(0.856,0.925)LASSO回归校准曲线Bootstrap法
(1 000次抽样);10 折交叉验证
列线图
李林莉等[21]AUC=0.968(0.937,0.999),灵敏度=0.969,特异度=0.906,Youden指数=0.875单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归校准曲线Bootstrap法
(1 000次抽样)
列线图
蒋丽丽等[22]AUC=0.852(0.811,0.904),灵敏度=0.826,特异度=0.914单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归H-L检验
(P=0.718)
Bootstrap法
(1 000次抽样)
公式
孙媛等[23]AUC=0.956(0.926,0.985),灵敏度=0.864,特异度=0.838单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归H-L检验(P=0.340)自身数据分割90公式
Chen等[24]AUC:12 h为0.816,24 h为0.786,36 h为0.759,48 h为0.744,60 h为0.705单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归、LASSO回归校准曲线;
H-L检验
Bootstrap法
(1 000次抽样)
92列线图
贾燕等[25]AUC=0.973(0.956,0.990),灵敏度=0.900,特异度=0.932单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归H-L检验
(P=0.988)
112列线图
Yang等[26]AUC=0.897(0.879,0.915),灵敏度=0.915, 特异度=0.746单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归、LASSO回归Brier评分;
校准曲线
Bootstrap法
(500次抽样)
779列线图
许红妍等[27]AUC=0.952(0.930,0.973),灵敏度=0.882,特异度=0.899单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归H-L检验
(P=0.856)
110公式
Liu等[28]AUC=0.863(0.860,0.868),灵敏度=0.8125,特异度=0.852,准确度=0.810全部纳入Hold-out验证;5折交叉验证机器学习算法的黑箱形式
胡璐璐等[29]AUC=0.865(0.823,0.907),灵敏度=0.755,特异度=0.829,Youden指数=0.584前向逐步回归法H-L检验
(P=0.954)
160公式
吴玲玲[30]AUC=0.877(0.837,0.918),灵敏度=0.858,特异度=0.773单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归H-L检验
(P=0.522);
校准曲线
Bootstrap法
(1 000次抽样)
列线图
万娜等[31]AUC=0.812(0.754,0.869),灵敏度=0.825,特异度=0.696单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归H-L检验
(P=0.257)
公式
常蓉等[32]AUC=0.732(0.702,0.765)单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归校准曲线Bootstrap法
(1 000次抽样)
71列线图
Zhang等[33]AUC=0.820(0.760,0.880),灵敏度=0.76,特异度=0.80逐步回归法(前向-后向)校准曲线Bootstrap法
(1 000次抽样)
44列线图
Kakajiwala等[34]梯度提升机模型AUC=0.860,灵敏度=0.918,特异度=0.922;仅跨膜压的模型AUC=0.857;仅过滤器压力的模型AUC=0.714单变量COX回归5折交叉验证COX模型
Fu等[35]AUC=0.790(0.709,0.871),灵敏度=0.769,特异度=0.727前向逐步回归法H-L检验
(P=0.301)
时间顺序分割123风险评分系统
), ArticleFig(id=1322925102198824982, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=CN, label=表4, caption=

ICU病人连续性肾脏替代治疗非计划下机风险预测模型的性能(n=19)

, figureFileSmall=null, figureFileBig=null, tableContent=
作者模型评价变量筛选方法校准方法模型验证模型呈现形式
内部验证外部验证(例)
Wang等[17]AUC=0.920,灵敏度=0.974,特异度=0.798全部纳入校准曲线滚动预测和在线学习算法框架
何淑雅等[18]AUC=0.936,灵敏度=0.800,特异度=1.000单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归校准曲线Bootstrap法
(1 000次抽样)
31列线图
刘倩等[19]AUC=0.978(0.958,0.997)LASSO回归H-L检验(P=0.939);校准曲线Bootstrap法
(1 000次抽样)
列线图
全梓林等[20]AUC=0.891(0.856,0.925)LASSO回归校准曲线Bootstrap法
(1 000次抽样);10 折交叉验证
列线图
李林莉等[21]AUC=0.968(0.937,0.999),灵敏度=0.969,特异度=0.906,Youden指数=0.875单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归校准曲线Bootstrap法
(1 000次抽样)
列线图
蒋丽丽等[22]AUC=0.852(0.811,0.904),灵敏度=0.826,特异度=0.914单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归H-L检验
(P=0.718)
Bootstrap法
(1 000次抽样)
公式
孙媛等[23]AUC=0.956(0.926,0.985),灵敏度=0.864,特异度=0.838单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归H-L检验(P=0.340)自身数据分割90公式
Chen等[24]AUC:12 h为0.816,24 h为0.786,36 h为0.759,48 h为0.744,60 h为0.705单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归、LASSO回归校准曲线;
H-L检验
Bootstrap法
(1 000次抽样)
92列线图
贾燕等[25]AUC=0.973(0.956,0.990),灵敏度=0.900,特异度=0.932单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归H-L检验
(P=0.988)
112列线图
Yang等[26]AUC=0.897(0.879,0.915),灵敏度=0.915, 特异度=0.746单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归、LASSO回归Brier评分;
校准曲线
Bootstrap法
(500次抽样)
779列线图
许红妍等[27]AUC=0.952(0.930,0.973),灵敏度=0.882,特异度=0.899单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归H-L检验
(P=0.856)
110公式
Liu等[28]AUC=0.863(0.860,0.868),灵敏度=0.8125,特异度=0.852,准确度=0.810全部纳入Hold-out验证;5折交叉验证机器学习算法的黑箱形式
胡璐璐等[29]AUC=0.865(0.823,0.907),灵敏度=0.755,特异度=0.829,Youden指数=0.584前向逐步回归法H-L检验
(P=0.954)
160公式
吴玲玲[30]AUC=0.877(0.837,0.918),灵敏度=0.858,特异度=0.773单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归H-L检验
(P=0.522);
校准曲线
Bootstrap法
(1 000次抽样)
列线图
万娜等[31]AUC=0.812(0.754,0.869),灵敏度=0.825,特异度=0.696单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归H-L检验
(P=0.257)
公式
常蓉等[32]AUC=0.732(0.702,0.765)单因素分析差异有统计学意义的变量(P<0.05)进行多因素Logistic回归校准曲线Bootstrap法
(1 000次抽样)
71列线图
Zhang等[33]AUC=0.820(0.760,0.880),灵敏度=0.76,特异度=0.80逐步回归法(前向-后向)校准曲线Bootstrap法
(1 000次抽样)
44列线图
Kakajiwala等[34]梯度提升机模型AUC=0.860,灵敏度=0.918,特异度=0.922;仅跨膜压的模型AUC=0.857;仅过滤器压力的模型AUC=0.714单变量COX回归5折交叉验证COX模型
Fu等[35]AUC=0.790(0.709,0.871),灵敏度=0.769,特异度=0.727前向逐步回归法H-L检验
(P=0.301)
时间顺序分割123风险评分系统
), ArticleFig(id=1322925102282711064, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=EN, label=Table 5, caption=

Evaluation of risk of bias and applicability of included studies(n=19)

, figureFileSmall=null, figureFileBig=null, tableContent=
作者偏倚风险适用性总体
研究对象预测因子结局数据分析研究对象预测因子结局偏倚风险适用性
Wang等[17]-++-?++-+
何淑雅等[18]?-+++++-+
刘倩等[19]-?+-?++-+
全梓林等[20]-?+-?++-+
李林莉等[21]-+?-+++-+
蒋丽丽等[22]?-+-+++-+
孙媛等[23]-+?++++-+
Chen等[24]??+-?++-+
贾燕等[25]-?+++++-+
Yang等[26]?++++++++
许红妍等[27]??+-+++-+
Liu等[28]-?+-+?+-+
胡璐璐等[29]--+++++-+
吴玲玲[30]--+?+++-+
万娜等[31]?-+-+++-+
常蓉等[32]??+++++-+
Zhang等[33]-?+++++-+
Kakajiwala等[34]--+?+++-+
Fu等[35]--+++++-+
), ArticleFig(id=1322925102400151577, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, language=CN, label=表5, caption=

纳入研究偏倚风险及适用性评价(n=19)

, figureFileSmall=null, figureFileBig=null, tableContent=
作者偏倚风险适用性总体
研究对象预测因子结局数据分析研究对象预测因子结局偏倚风险适用性
Wang等[17]-++-?++-+
何淑雅等[18]?-+++++-+
刘倩等[19]-?+-?++-+
全梓林等[20]-?+-?++-+
李林莉等[21]-+?-+++-+
蒋丽丽等[22]?-+-+++-+
孙媛等[23]-+?++++-+
Chen等[24]??+-?++-+
贾燕等[25]-?+++++-+
Yang等[26]?++++++++
许红妍等[27]??+-+++-+
Liu等[28]-?+-+?+-+
胡璐璐等[29]--+++++-+
吴玲玲[30]--+?+++-+
万娜等[31]?-+-+++-+
常蓉等[32]??+++++-+
Zhang等[33]-?+++++-+
Kakajiwala等[34]--+?+++-+
Fu等[35]--+++++-+
)], attaches=null, journal=Journal(id=1220037649855897604, delFlag=0, nameCn=护理研究, nameEn=Chinese Nursing Research, nameHistory1=null, nameHistory2=null, issn=1009-6493, eissn=null, cn=14-1272/R, coden=null, periodic=3, language=CN, oaType=null, ccby=null, superviseOffice=null, ownerOffice=null, pubOffice=null, editorOffice=null, officeType=null, aims=null, clcCode=null, officeProv=null, officeCity=null, officeAddr=null, officeZip=null, officeEmail=null, officePhone=null, editDirector=null, officeDirector=null, officeDirectorPhone=null, officeStaffNum=null, officeEmpNum=null, coverPicUrl=5ND/w5RQYz//x8ucn+e6Vw==, journalPrice=null, startedYear=null, abbrevIsoEn=Chinese Nursing Research, journalRemark=null, publicationField=null, createdTime=1768809242933, updatedTime=1789628561524, createdBy=18614031015, updatedBy=13041195026, firstLetterCn=H, firstLetterEn=H, subjectCode=Medical and Pharmaceutical Sciences, subjectName=null, subjectCodeEn=Medical and Pharmaceutical Sciences, subjectNameEn=null, picCn=5ND/w5RQYz//x8ucn+e6Vw==, picEn=vXneBBf6WfTz/ls4yy3nnA==, jcr=null, cjcr=null, exts=[JournalExt(id=1307360202571928186, language=CN, name=护理研究, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1789628561871, updatedTime=1789628561871, createdBy=13041195026, updatedBy=13041195026, submissionGuidelinesUrl=, submissionAuthorUrl=https://journal.ids.fzyun.cn/auth/realms/journal/protocol/openid-connect/auth?client_id=journal-sxyxqks-author&redirect_uri=https%3A%2F%2Fgj.sxyxqks.com%2Foauth%2Fcallback&response_type=code&scope=phone+openid+email+profile&state=1de4c13f-4807-4ea4-8d8a-5, submissionEditorUrl=https://journal.ids.fzyun.cn/auth/realms/journal/protocol/openid-connect/auth?client_id=journal-sxyxqks-author&redirect_uri=https%3A%2F%2Fgj.sxyxqks.com%2Foauth%2Fcallback&response_type=code&scope=phone+openid+email+profile&state=321a724c-d51d-4f08-a85e-2, submissionReviewUrl=https://journal.ids.fzyun.cn/auth/realms/journal/protocol/openid-connect/auth?client_id=journal-sxyxqks-author&redirect_uri=https%3A%2F%2Fgj.sxyxqks.com%2Foauth%2Fcallback&response_type=code&scope=phone+openid+email+profile&state=dadec7f2-d93c-4f73-8f97-e, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""}), JournalExt(id=1307360202618065531, language=EN, name=Chinese Nursing Research, nameHistory1=null, nameHistory2=null, managedBy=, sponsoredBy=, publishedBy=, editorOffice=, officeProv=null, officeCity=null, officeAddr=, officeZip=, editDirector=, officeDirector=null, officePhone=null, coverPicUrl=null, journalRemark=, submitArticleUrl=null, websiteUrl=, createdTime=1789628561882, updatedTime=1789628561882, createdBy=13041195026, updatedBy=13041195026, submissionGuidelinesUrl=, submissionAuthorUrl=https://journal.ids.fzyun.cn/auth/realms/journal/protocol/openid-connect/auth?client_id=journal-sxyxqks-author&redirect_uri=https%3A%2F%2Fgj.sxyxqks.com%2Foauth%2Fcallback&response_type=code&scope=phone+openid+email+profile&state=1de4c13f-4807-4ea4-8d8a-5, submissionEditorUrl=https://journal.ids.fzyun.cn/auth/realms/journal/protocol/openid-connect/auth?client_id=journal-sxyxqks-author&redirect_uri=https%3A%2F%2Fgj.sxyxqks.com%2Foauth%2Fcallback&response_type=code&scope=phone+openid+email+profile&state=321a724c-d51d-4f08-a85e-2, submissionReviewUrl=https://journal.ids.fzyun.cn/auth/realms/journal/protocol/openid-connect/auth?client_id=journal-sxyxqks-author&redirect_uri=https%3A%2F%2Fgj.sxyxqks.com%2Foauth%2Fcallback&response_type=code&scope=phone+openid+email+profile&state=dadec7f2-d93c-4f73-8f97-e, submissionCeEditorUrl=, submissionAeEditorUrl=, option={"copyright":""})], databaseList=null, tenantJournalId=1220038315760373764, websiteList=[Website(id=1220043903038837076, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1220038315760373764, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/hlyj/CN, language=CN, createTime=1768810733804, createBy=18614031015, updateTime=1768811130580, updateBy=18614031015, name=护理研究-中文, tplId=1146099689490845704, title=护理研究, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1228001613021904925, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=articleTextType, value=kx, createTime=1770707999711, updateTime=1770707999711, creator=18614031015, updator=18614031015), WebsiteProps(id=1228001613005127706, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=banner, value=null, createTime=1770707999707, updateTime=1770707999707, creator=18614031015, updator=18614031015), WebsiteProps(id=1228001613038682144, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=grayFlag, value=0, createTime=1770707999715, updateTime=1770707999715, creator=18614031015, updator=18614031015), WebsiteProps(id=1228001613000933401, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=logo, value=https://castjournals.cast.org.cn/joweb/hlyj/CN/file/pic?fileId=pB29yYO+7WdTp0HLQ4KSzg==, createTime=1770707999706, updateTime=1770707999706, creator=18614031015, updator=18614031015), WebsiteProps(id=1228001613047070754, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=minRunFlag, value=0, createTime=1770707999717, updateTime=1770707999717, creator=18614031015, updator=18614031015), WebsiteProps(id=1228001613017710620, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/hlyj/CN/file/pic, createTime=1770707999710, updateTime=1770707999710, creator=18614031015, updator=18614031015), WebsiteProps(id=1228001613042876449, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=silenceFlag, value=0, createTime=1770707999716, updateTime=1770707999716, creator=18614031015, updator=18614031015), WebsiteProps(id=1228001613013516315, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_cn_619/, createTime=1770707999709, updateTime=1770707999709, creator=18614031015, updator=18614031015), WebsiteProps(id=1228001613026099230, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=themeColor, value=null, createTime=1770707999712, updateTime=1770707999712, creator=18614031015, updator=18614031015), WebsiteProps(id=1228001613034487839, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903038837076, code=themeStyle, value=null, createTime=1770707999714, updateTime=1770707999714, creator=18614031015, updator=18614031015)]), Website(id=1220043903097557352, webName=null, webTitle=null, webDomain=null, webCopyrigh=null, webIpcNo=null, seoTitle=null, seoKeywords=null, seoDescription=null, tenantJournalId=null, journalId=1220038315760373764, journalNameCn=null, journalNameEn=null, grayFlag=null, tenantId=1146029695717560320, platformId=null, journalGroupId=null, journalGroupNameCn=null, journalGroupNameEn=null, type=1, domain=https://castjournals.cast.org.cn/joweb/hlyj/EN, language=EN, createTime=1768810733819, createBy=18614031015, updateTime=1768811154181, updateBy=18614031015, name=护理研究-英文, tplId=1146101810881728533, title=Chinese Nursing Research, delFlag=0, indexPage=/home, props=[WebsiteProps(id=1220045841042166147, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=articleTextType, value=kx, createTime=1768811195860, updateTime=1768811195860, creator=18614031015, updator=18614031015), WebsiteProps(id=1220045841017000320, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=banner, value=null, createTime=1768811195854, updateTime=1768811195854, creator=18614031015, updator=18614031015), WebsiteProps(id=1220045841063137670, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=grayFlag, value=0, createTime=1768811195865, updateTime=1768811195865, creator=18614031015, updator=18614031015), WebsiteProps(id=1220045841008611711, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=logo, value=https://castjournals.cast.org.cn/joweb/hlyj/EN/file/pic?fileId=pB29yYO+7WdTp0HLQ4KSzg==, createTime=1768811195852, updateTime=1768811195852, creator=18614031015, updator=18614031015), WebsiteProps(id=1220045841075720584, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=minRunFlag, value=0, createTime=1768811195868, updateTime=1768811195868, creator=18614031015, updator=18614031015), WebsiteProps(id=1220045841033777538, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=picServerUrl, value=https://castjournals.cast.org.cn/joweb/hlyj/EN/file/pic, createTime=1768811195858, updateTime=1768811195858, creator=18614031015, updator=18614031015), WebsiteProps(id=1220045841071526279, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=silenceFlag, value=0, createTime=1768811195867, updateTime=1768811195867, creator=18614031015, updator=18614031015), WebsiteProps(id=1220045841025388929, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=staticResourcePath, value=https://castjournals.cast.org.cn/joweb/cast_kjdb_en_623/, createTime=1768811195857, updateTime=1768811195857, creator=18614031015, updator=18614031015), WebsiteProps(id=1220045841046360452, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=themeColor, value=null, createTime=1768811195861, updateTime=1768811195861, creator=18614031015, updator=18614031015), WebsiteProps(id=1220045841054749061, tenantId=1146029695717560320, journalId=null, journalGroupId=null, siteId=1220043903097557352, code=themeStyle, value=null, createTime=1768811195863, updateTime=1768811195863, creator=18614031015, updator=18614031015)])], journalTitle=护理研究, weixinUrl=null, journalUrl=https://www.hlyjzz.com/, iacademicId=null, status=1, seqNo=null, journalTitleEn=Chinese Nursing Research, journalPhotoCn=5ND/w5RQYz//x8ucn+e6Vw==, journalPhotoEn=vXneBBf6WfTz/ls4yy3nnA==, journalFirstLetter=H, journalRecommend=null, journalNew=null, journalCollection=null, jcrJf=null, cjcrJf=null, jcrJfStr=null, cjcrJfStr=null, submissionFirstDecision=null, sciSubjectClassification=null, casSubjectClassification=null, citeScore=null, totalCitationFrequency=null, icpCode=null, psCode=null, advertisingLicenseCode=null, copyrightInformation=null, country=null, option=, provinceCode=null, provinceName=null, collectFlag=false, interPubPlatform=, interPubPlatformUrl=null), detailUrlCn=https://castjournals.cast.org.cn/joweb/hlyj/CN/10.12102/j.issn.1009-6493.2026.16.023, detailUrlEn=https://castjournals.cast.org.cn/joweb/hlyj/EN/10.12102/j.issn.1009-6493.2026.16.023, pdfUrlCn=https://castjournals.cast.org.cn/joweb/hlyj/CN/PDF/10.12102/j.issn.1009-6493.2026.16.023, pdfUrlEn=https://castjournals.cast.org.cn/joweb/hlyj/EN/PDF/10.12102/j.issn.1009-6493.2026.16.023, aliStartDate=0, aliEndDate=0, collectionFlag=false, citedCount=null, citedUrl=null, previewStatus=0, delFlag=0, hasFullText=1, orderTime=1787587200000, fullTextJson=null, articleText=null, reference=null)
收藏切换
ICU病人连续性肾脏替代治疗非计划下机风险预测模型的范围综述
收藏切换
王梦倩 , 刘秀梅 , 丛珊珊 , 贾云艳 , 唐妍 , 康艳楠 *, *
护理研究 | 科研综述 2026,40(16): 2925-2934
收起
收藏切换
护理研究 |科研综述 2026 , 40 (16) : 2925 -2934
ICU病人连续性肾脏替代治疗非计划下机风险预测模型的范围综述
全屏
[Author(id=1322925090496717795, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1322925091255886821, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925090496717795, language=EN, stringName=Mengqian WANG, firstName=Mengqian, middleName=null, lastName=WANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1322925091692094438, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925090496717795, language=CN, stringName=王梦倩, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1大连医科大学附属第一医院,辽宁 116011, bio={"content":"

王梦倩,硕士研究生

"}, bioImg=null, bioContent=

王梦倩,硕士研究生

, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1322925090219893727, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, xref=1, ext=[AuthorCompanyExt(id=1322925090228282336, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China), AuthorCompanyExt(id=1322925090240865249, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1大连医科大学附属第一医院,辽宁 116011)])]), Author(id=1322925093390787560, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, orderNo=1, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1322925093831189482, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925093390787560, language=EN, stringName=Xiumei LIU, firstName=Xiumei, middleName=null, lastName=LIU, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1322925094233842668, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925093390787560, language=CN, stringName=刘秀梅, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1大连医科大学附属第一医院,辽宁 116011, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1322925090219893727, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, xref=1, ext=[AuthorCompanyExt(id=1322925090228282336, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China), AuthorCompanyExt(id=1322925090240865249, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1大连医科大学附属第一医院,辽宁 116011)])]), Author(id=1322925095026566126, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, orderNo=2, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1322925095458579440, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925095026566126, language=EN, stringName=Shanshan CONG, firstName=Shanshan, middleName=null, lastName=CONG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1322925095924147185, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925095026566126, language=CN, stringName=丛珊珊, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1大连医科大学附属第一医院,辽宁 116011, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1322925090219893727, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, xref=1, ext=[AuthorCompanyExt(id=1322925090228282336, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China), AuthorCompanyExt(id=1322925090240865249, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1大连医科大学附属第一医院,辽宁 116011)])]), Author(id=1322925096037393395, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, orderNo=3, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1322925097731892215, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925096037393395, language=EN, stringName=Yunyan JIA, firstName=Yunyan, middleName=null, lastName=JIA, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1322925097832555512, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925096037393395, language=CN, stringName=贾云艳, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1大连医科大学附属第一医院,辽宁 116011, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1322925090219893727, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, xref=1, ext=[AuthorCompanyExt(id=1322925090228282336, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China), AuthorCompanyExt(id=1322925090240865249, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1大连医科大学附属第一医院,辽宁 116011)])]), Author(id=1322925097924830202, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, orderNo=4, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1322925098000327676, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925097924830202, language=EN, stringName=Yan TANG, firstName=Yan, middleName=null, lastName=TANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1322925098067436541, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925097924830202, language=CN, stringName=唐妍, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1大连医科大学附属第一医院,辽宁 116011, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1322925090219893727, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, xref=1, ext=[AuthorCompanyExt(id=1322925090228282336, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China), AuthorCompanyExt(id=1322925090240865249, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1大连医科大学附属第一医院,辽宁 116011)])]), Author(id=1322925098134545407, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, orderNo=5, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=15165067126@163.com, emailSecond=null, emailThird=null, correspondingAuthor=1, authorType=1, ext={EN=AuthorExt(id=1322925098214236160, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925098134545407, language=EN, stringName=Yannan KANG, firstName=Yannan, middleName=null, lastName=KANG, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1322925098277150721, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, authorId=1322925098134545407, language=CN, stringName=康艳楠, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=*, *, address=1大连医科大学附属第一医院,辽宁 116011, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null)}, companyList=[AuthorCompany(id=1322925090219893727, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, xref=1, ext=[AuthorCompanyExt(id=1322925090228282336, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China), AuthorCompanyExt(id=1322925090240865249, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322925087749448664, companyId=1322925090219893727, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1大连医科大学附属第一医院,辽宁 116011)])])]
王梦倩, 刘秀梅, 丛珊珊, 贾云艳, 唐妍, 康艳楠*, *
作者信息
  • 1大连医科大学附属第一医院,辽宁 116011
通讯作者:
康艳楠,E-mail:
KANG Yannan, E-mail:
作者简介:

王梦倩,硕士研究生

Risk predictive models of unplanned discontinuation of continuous renal replacement therapy in ICU patients:a scoping review
Mengqian WANG, Xiumei LIU, Shanshan CONG, Yunyan JIA, Yan TANG, Yannan KANG
Affiliations
  • 1The First Affiliated Hospital of Dalian Medical University, Liaoning 116011 China
出版时间: 2026-08-25 doi: 10.12102/j.issn.1009-6493.2026.16.023
文章导航
收藏切换
目的

综述ICU病人连续性肾脏替代治疗(CRRT)非计划下机风险预测模型,为医护人员选择或开发合适的风险预测模型提供循证依据。

方法

系统检索OVID、CINAHL、PubMed、Web of Science、Cochrane Library、EMbase、中国知网、维普数据库、万方数据库、中国生物医学文献数据库等中英文数据库中的相关研究,检索时限为建库至2025年8月12日。

结果

共纳入19项研究,涉及28个模型,样本量为79~2 531例。28个模型的受试者工作特征曲线下面积为0.705~0.978,17项研究报告了模型校准方法。19项研究总体适用性较好,但仍存在较高的偏倚风险,主要集中在数据分析领域。

结论

ICU病人CRRT非计划下机风险预测模型尚处在发展阶段,未来应进一步提高相关模型研究的质量,尤其是在预测因子选择、模型评价等方面应更加规范,以期为临床制定个体化干预策略提供有效工具。

重症监护室  /  连续性肾脏替代治疗  /  非计划下机  /  预测模型  /  范围综述  /  循证护理
Objective

To review the risk prediction models of unplanned discontinuation of continuous renal replacement therapy(CRRT) in ICU patients,and to provide evidence-based guidance for healthcare providers in selecting or developing appropriate risk prediction models.

Methods

This study systematically retrieved relevant studies from Chinese and English databases such as OVID,CINAHL,PubMed,Web of Science,Cochrane Library,EMbase,CNKI,VIP,WanFang,and China Biomedical Literature Database.The search period was from the establishment of the databases to August 12, 2025.

Results

A total of 19 studies were included,involving 28 models.Sample sizes ranged from 79 to 2 531 cases.The area under curve(AUC) for the 28 models ranged from 0.705 to 0.978.Calibration methods were reported in 17 studies.The overall applicability of the 19 studies was good,but there was still a relatively high risk of bias,mainly concentrated in the field of data analysis.

Conclusions

The risk prediction models of unplanned discontinuation of CRRT in ICU patients are still in the development stage.Future research should further improve the quality of related model studies,especially in aspects such as the selection of predictive factors and model evaluation,so as to provide effective tools for clinical practitioners to formulate individualized intervention strategies.

intensive care unit,ICU  /  continuous renal replacement therapy  /  unplanned disconnection  /  prediction model  /  scoping review  /  evidence-based nursing
王梦倩, 刘秀梅, 丛珊珊, 贾云艳, 唐妍, 康艳楠. ICU病人连续性肾脏替代治疗非计划下机风险预测模型的范围综述. 护理研究, 2026 , 40 (16) : 2925 -2934 . DOI: 10.12102/j.issn.1009-6493.2026.16.023
Mengqian WANG, Xiumei LIU, Shanshan CONG, Yunyan JIA, Yan TANG, Yannan KANG. Risk predictive models of unplanned discontinuation of continuous renal replacement therapy in ICU patients:a scoping review[J]. Chinese Nursing Research, 2026 , 40 (16) : 2925 -2934 . DOI: 10.12102/j.issn.1009-6493.2026.16.023
连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)是指基于扩散、超滤、对流和吸附的生理学原理模拟肾脏功能,缓慢清除体内水分和内毒素等物质的一种血液净化方式[1-2]。我国发布的《血液净化标准操作规程》[3]推荐出现危及生命的并发症时应立即启动连续性肾脏替代治疗,目前连续性肾脏替代治疗的治疗已经成为抢救急危重病人的最有效的方法之一[4]。ICU病人常合并凝血功能障碍、免疫功能抑制及多器官功能衰竭等严重并发症,致使病人对连续性肾脏替代治疗的治疗耐受性差,是非计划性下机的重要原因之一[5-6]。连续性肾脏替代治疗非计划下机是指病人在实施连续性肾脏替代治疗过程中因各种原因被迫停止治疗[7],治疗时间短于24 h或没有完成连续性肾脏替代治疗目标而提前终止治疗的现象[8-9],其发生率较高,为17.9%~74.6%[10-11]。非计划下机不仅会影响连续性肾脏替代治疗的治疗剂量,还可能导致病人液体超负荷、电解质紊乱和代谢紊乱,增加感染风险和住院时间,最终增加病人的死亡风险[12-13]。因此,减少连续性肾脏替代治疗非计划下机的发生对改善ICU病人的预后至关重要[14]。早期识别连续性肾脏替代治疗非计划性下机高风险病人,及时对其采取针对性干预措施具有重要临床意义。近年来,连续性肾脏替代治疗非计划下机相关的风险预测模型研究逐渐增多,但其研究质量参差不齐,高质量循证医学证据的应用受到限制。本研究对ICU病人连续性肾脏替代治疗非计划下机风险预测模型的基本特征、构建方法、预测因子及性能等方面进行范围综述,以期为制定个性化的连续性肾脏替代治疗方案提供参考依据,并为未来连续性肾脏替代治疗非计划下机风险预测模型的研究提供方向。
ICU病人连续性肾脏替代治疗非计划下机的风险预测模型的构建方法有哪些?纳入哪些预测因子?这些模型的性能如何?使用了哪些校准方法?模型是否进行了内外部验证?采用哪种内外部验证方法?
系统检索OVID、CINAHL、PubMed、EMbase、Web of Science、Cochrane Library、中国知网、维普数据库、万方数据库、中国生物医学文献数据库(CBM)等中英文数据库,检索时限为建库至2025年8月12日。采用主题词与自由词相结合的方法,并通过文献追溯法进行检索。中文数据库以中国知网为例,检索式为:(SU=‘重症监护’+‘重症’+‘重症病人’+‘ICU’) AND(SU=‘连续性肾脏替代治疗’+‘CRRT’+‘血液净化’) AND (SU=‘非计划性下机’+‘非计划下机’+‘意外’+‘非计划’+‘非计划撤机’+‘中断’+‘意外’)。英文数据库以PubMed为例,检索策略如下:
#1 intensive care unit[MeSH Terms] OR critical care[MeSH Terms] OR critical illnesses[Title/Abstract] OR intensive care[Title/Abstract] OR ICU[Title/Abstract] OR intensive care[Title/Abstract]
#2 continuous renal replacement therapy[MeSH Terms] OR continuous blood purification[Title/Abstract] OR CRRT[Title/Abstract] OR continuous renal replacement therap*[Title/Abstract] OR CVVH[Title/Abstract] OR CVVHD[Title/Abstract] OR CVVHDF[Title/Abstract]
#3 extracorporeal circulation clotting[Title/Abstract] OR filter lifespan[Title/Abstract] OR circuit lifeblood coagulation[Title/Abstract] OR coagulation[Title/Abstract] OR unplanned disembarkation[Title/Abstract] OR longevity[Title/Abstract] OR unplanned[Title/Abstract] OR premature termination[Title/Abstract] OR unexpected stop*[Title/Abstract] OR unscheduled end*[Title/Abstract] OR circuit failure[Title/Abstract] OR filter clotting[Title/Abstract] OR weaning[Title/Abstract] OR discontinuation[Title/Abstract] OR cessation[Title/Abstract] OR failure[Title/Abstract]
#4 risk assessment[MeSH Terms] OR models,statistical[MeSH Terms] OR risk prediction model[Title/Abstract] OR forecasting[Title/Abstract] OR Nomogram[Title/Abstract] OR risk analysis[Title/Abstract] OR screening[Title/Abstract] OR mass screening[Title/Abstract] OR tool*[Title/Abstract] OR score*[Title/Abstract] OR machine learning[Title/Abstract] OR filter failure[Title/Abstract]
#5 #1 AND #2 AND #3 AND #4
纳入标准:研究对象为行连续性肾脏替代治疗的病人;研究内容为ICU病人连续性肾脏替代治疗非计划下机风险预测模型构建或验证的研究;文章研究类型包括横断面研究、队列研究以及病例对照研究。排除标准:会议摘要;重复发表;无法获取全文;无法提取数据。
2名研究者根据CHARMS清单[15]制定标准化表格提取数据,并通过EndNote进行文献管理,根据标题、摘要和全文阅读进行文献筛选。对纳入研究的基本特征、模型建立情况及模型性能等信息进行归纳整理。所有流程均采用双人独立操作及交叉核验,如有分歧,与第3名研究者共同讨论解决。
2名研究者分别参照Cochrane协作网推荐的预测模型偏倚风险评估工具(PROBAST)[16],独立完成对纳入文献的偏倚风险及临床适用性的评估。偏倚风险的评估涵盖研究对象、预测因子、结局指标及统计分析4个方面,而临床适用性评估则主要基于研究对象、预测因子和结局指标进行判断。
共检索到2 793篇文献,其中,中国知网112篇,维普数据库129篇,万方数据库156篇,CBM 49篇,PubMed 885篇,EMbase 228篇,Web of Science 404篇,Cochrane Library 459篇,CINAHL 192篇,OVID 179篇。经初步筛选及全文阅读后复筛,最终纳入文献19篇[17-35],其中中文12篇,英文7篇。
纳入的19项文献[17-35]中3项[18,24,35]为前瞻性队列研究,16项[17,19-23,25-34]为回顾性队列研究;主要预测结局为各种原因引起的连续性肾脏替代治疗非计划下机,以滤器凝血导致的非计划下机为主。连续性肾脏替代治疗非计划下机的指征:1)过滤器跨膜压>300 mmHg及较高的过滤器凝血分级,0级为过滤器内无凝血或仅少量凝血,Ⅰ级为过滤器凝血面积小于10%,Ⅱ级为过滤器凝血面积为10%~50%,Ⅲ级为过滤器凝血面积大于50%;2)过滤器中空纤维血凝块生成或连续性肾脏替代治疗通路中存在肉眼可见的1个或多个血凝块致连续性肾脏替代治疗血流通路堵塞;3)各种原因导致的血泵停止且无法恢复。纳入文献的基本特征见表1。
纳入的19项研究[17-35]中共涉及28个模型,样本量为79~2 531例。多数研究[18-23,25-27,29-33]采用Logistic回归进行建模,3项研究[24,34-35]通过COX比例风险回归构建模型,3项研究[17,28,34]采用决策树、支持向量机、随机森林等机器学习算法建模。9项研究[17-18,20-21,23,25,27,31-32]未阐述有关缺失数据及处理的内容,缺失数据处理方法主要为直接删除[19,22,29,35]、多重插补[24,26,28,30]。其他模型建立情况见表2。预测模型纳入预测因子1~13个,部分预测因子重复出现,报告重复出现3次及以上预测因子见表3。
纳入的19项研究[17-35]中模型受试者工作特征曲线下面积(AUC)为0.705~0.978,总体预测性能良好(AUC>0.7)。有2项研究[28,34]未给出模型校准方法,10项研究[19,22-25,27,29-31,35]通过Hosmer-Lemeshow(H-L)拟合优度检验给出了P值,P≥0.05表明模型一致性良好,10项研究[17-21,24,26,30,32-33]通过校准曲线进行校准。在模型验证方面,10项研究[18-22,24,26,30,32-33]报告通过Bootstrap法进行内部验证,10项研究[18,23-27,29,32-33,35]运用了外部验证的方法。其他模型性能见表4。
根据PROBAST评估,纳入19项研究[17-35]整体存在高偏倚风险,适用性风险较低。其高偏倚风险主要集中在预测因子和数据分析领域。16项[17,19-23,25-34]回顾性研究中预测因子在结局发生后测量可能导致预测效能与真实情况存在显著偏差;2项研究[21,34]的样本量较少,增加模型过拟合风险;4项研究[22,30,32,35]将连续性变量转化为分类变量进行处理;9项研究[17-18,20-21,23,25,27,31-32]未阐述有关缺失数据及处理的内容;4项研究[19,22,29,35]报告缺失数据处理为直接删除,可能导致结果偏差,模型区分能力被高估;多数研究[18,21-27,30,32]基于单变量分析筛选变量;普遍忽略多重共线性处理,如血流量与跨膜压、APTT与凝血酶原时间之间是否存在高度相关,可能导致回归系数估计偏差或检验连续变量非线性关系,易诱发模型设定偏倚及过拟合;10项研究[18,23-27,29,32-33,35]进行了外部验证,缺乏外部验证会导致泛化性证据不足,可能会出现模型性能评估上的乐观偏差,见表5。
本研究结果显示,连续性肾脏替代治疗非计划下机预测模型中各模型纳入的预测因子差异显著,变量组合均不一致。归纳模型纳入的预测因子可分为病人自身因素、血流动力学因素、凝血功能因素及其他治疗因素4个类别,其中,血小板计数、APTT、血流速度、跨膜压、血流量不足为主要预测因子,在模型中出现频次高,提示与非计划下机有较强的关联性。此外,由于各模型对血流量与跨膜压、APTT与凝血酶原时间等潜在共线性变量的处理存在差异,进一步导致模型预测因子结果差异。临床医护人员应重点关注上述预测因子,规范相关数据的采集与监测,精准识别高危风险并实施针对性护理干预,以降低非计划下机的发生风险。未来研究应深入分析连续性肾脏替代治疗非计划下机影响因素,在建模前充分利用数据挖掘技术,从病人基线资料、评估量表、实验室指标及病史资料中全面筛选潜在预测因子,同时结合临床实际与病人个体情况,根据脓毒症、急性肾损伤等不同疾病特征甄选合适的变量纳入模型,从而提升连续性肾脏替代治疗非计划下机预测模型的准确性与临床适用性。
本研究共纳入了28个预测模型,模型AUC为0.705~0.978,表明预测性能良好,但大部分存在较高的偏倚风险,主要源于研究数据处理盲法的缺失、缺失值处理方法的描述不足、预测因子筛选的方法不当以及缺乏外部验证等,其结局指标为连续性肾脏替代治疗非计划下机,判定标准参考《血液净化标准操作规程》,定义客观、可量化,避免主观判定偏差,同时判定依据基于设备监测数据和肉眼观察,均为临床可验证指标,无判定偏倚。为优化未来模型构建,建议从研究对象、预测因子、结果、统计分析4个方面改进。1)研究对象纳入适宜样本量以确保数据准确性与代表性,并降低人群异质性。样本量需要满足每个自变量对应的事件数(EPV)20倍以上[36],以增强模型可靠性。EPV<10可能会导致过度拟合;验证样本量<100例可能会引入偏倚[37],机器学习算法尤其需要大规模数据以维持模型稳定性[38]。选择合适的方法进行缺失值的处理,在数据整理与方案设计阶段应注意缺失值的处理,降低模型的偏倚风险[39]。2)预测因子领域:连续性变量原则上应保留其连续属性,避免不必要的类别转换。如确需转换,应通过内部验证并采用回归系数收缩法以减少过度拟合[40]。在测量预测因子和结局指标时,应采用盲法评估,最大限度减少主观偏倚。3)结果领域:预测因子评估和结局评估的时间间隔应合理设置,以确保结果记录的准确性。4)统计分析领域:预测模型研究必须包含充分的内部验证与外部验证,以评估过度拟合风险、优化模型参数、提升性能,从而支持临床转化决策。避免仅依赖单变量分析筛选预测因子,这种方法难以全面评估变量间的共线性及交互作用,并且可能由于自变量的缺失导致结果产生偏倚[16]。在后续开发风险预测模型时,建议遵循PROBAST的标准与规范,着重关注模型构建过程中的细节处理和验证环节,从而为临床实践提供更科学、精准的预测工具。
本研究纳入的19项研究[17-35]发表时间集中在近几年,表明ICU病人连续性肾脏替代治疗非计划下机风险预测模型日益受到临床关注。但目前普遍缺乏外部验证且多为单中心,限制了其预测效能及泛化能力。其单中心研究可能受地域医疗水平、病人基线特征、治疗方案同质化等因素限制;缺乏外部验证会影响模型的可靠性、泛化性和临床实用性,阻碍临床转化与应用。同时在模型构建方面,现有的建模方法选择过于单一,大多采用传统的Logistic回归建立模型,易存在处理多重共线性数据的局限性,机器学习算法在处理数据和特征筛选方面表现出更高的包容性和灵活性,可提升模型的预测性能,其构建的模型预测性能多数优于Logistic回归构建的模型,因此临床护理研究需要与信息技术进行紧密结合[39]。Wang等[17]构建LSTM模型通过50 min周期和滚动预测机制和在线学习,实现跨膜压趋势的实时更新,平均预警时间达23 min,为临床干预提供充足窗口。Liu等[28]通过回顾性分析采用8种机器学习算法构建预测模型,并通过SHAP分析识别出血小板、滤过分数、三酰甘油为影响凝血风险的关键预测因子,为临床制定个性化连续性肾脏替代治疗策略、降低回路凝血风险提供了有效参考。Yang等[26,33]通过Logistic回归模型虽在区分度和校准度上表现优异,但多基于基线静态指标,无法捕捉治疗过程中病人生理状态的动态变化,预警时效性较弱。虽然机器学习算法可以对大数据进行高效管理,但Logistic回归模型的临床可操作性更强,列线图可通过可视化评分直接计算风险概率,医护人员无需专业算法背景也可应用,而LSTM模型需依赖连续性肾脏替代治疗设备实时数据接口与算法部署,对基层医院技术条件要求较高。在未来研究中,可尝试运用随机森林、支持向量机等机器学习算法构建相关预测模型。
现阶段,ICU病人连续性肾脏替代治疗非计划下机风险预测模型的相关研究多集中在模型的开发上,较少应用于临床,呈现出重开发轻应用的不平衡局面,可能是由于部分模型的复杂性、应用环境的差异以及医护人员基于数字决策指导临床实践的意识不强,同时由于病人病情和治疗情况不断变化,模型需要持续更新以适应新的数据和临床情况。但目前很多模型开发后缺乏后续的更新维护,随着时间推移模型的预测准确性下降,难以满足临床实际需求,从而阻碍了其在临床中的长期应用。本研究纳入的各类连续性肾脏替代治疗非计划下机风险预测模型,为临床护理提供了基于病人群体特征与治疗参数的分层干预依据,可助力护理人员实现个体化评估并进行针对性干预的精准护理模式。针对老年急性心力衰竭病人,借助列线图可快速完成基线风险筛查;对导管出口功能不良评分>30分或连续性肾脏替代治疗每小时治疗量>160 mL的高危病人,护理中应优先协助医生选择股静脉置管以降低导管相关风险,并通过调整置换液速率减少血液浓缩[18]。对于重症胰腺炎病人,若模型提示肝素抗凝风险较高,护理人员需重点落实局部枸橼酸抗凝方案的执行,密切监测血流速度,确保维持在180 mL/min以上,避免因血流缓慢导致血液滞留引发凝血[21]。针对无抗凝连续性肾脏替代治疗病人,通过Liu等[28]构建的模型,当识别病人血小板计数>150×109/L、滤过分数>25%时,需将跨膜压监测频次提升至2 h监测1次,动态观察回路状态,必要时协助医生调整超滤速率以降低凝血风险。对于局部枸橼酸抗凝的病人,依据Chen等[24]模型提示,当静脉压>45 mmHg 时,应立即执行管路冲洗操作,防止凝血进展导致治疗中断。此外,Wang等[17]提出的LSTM模型可与连续性肾脏替代治疗设备终端集成,实现跨膜压动态监测与自动预警,该功能在夜班、节假日等医护人力相对紧张的场景中优势显著,能有效减少因人工监测疏漏导致的非计划下机,为护理安全提供技术支撑。
医护人员对于非计划下机以及预测模型的认知及接受度可能不足[41],建议强化对医护人员的培训和教育,提升对数字决策支持工具的信任度,促进模型向临床实践的转化。为提升临床工作效率,可将预测模型整合至电子病历及医疗管理信息系统中,并借助网页计算器、评分量表或热力图等可视化形式进行展示,构建适用于ICU病人连续性肾脏替代治疗非计划下机的自动化评估工具,实现非计划下机风险的实时评估,从而显著提高护理工作的效率与质量。
现有模型整体展现出较好的性能以及适用性,然而仍存在较高的偏倚风险,且缺少外部验证。未来的研究需借助大样本量、前瞻性、多中心设计,且经过严格内外部验证的研究,以构建更为可靠的预测模型。同时还要结合人工智能和大数据技术,强调模型应用与临床经验的融合,开发更为精准且可动态更新的预测工具,从而对ICU病人连续性肾脏替代治疗非计划下机风险进行及时评估,并为个体化干预提供循证依据。

参考文献 引证文献
排序方式:
1
Luo T G,Lin F,Huang H C.Clinical impact and safety of continuous renal replacement therapy in critically ill patients with solid tumors and acute kidney injury:a retrospective cohort analysis[J].American Journal of Cancer Research,2025,15(7):3267-3285.
2
Alkubati S A,Alfaraaj A A,Almoliky M A,et al.Exploring the readiness of critical care in implementing continuous renal replacement therapy in hail hospitals,Saudi Arabia:findings for acute kidney injury patient care improvement[J].Healthcare,2025,13(18).
3
陈香美.血液净化标准操作规程[M].北京:人民卫生出版社,2021:1.
4
Raina R,Kashani K,Sethi S K,et al.Liberation from continuous renal replacement therapy due to renal recovery in adults and children:a literature review and Delphi consensus on clinical practice[J].Critical Care,2025,29(1):287.
5
Zeng Z,Shen Y Q,Wan L,et al.Risk factors for unplanned weaning of continuous renal replacement therapy in ICU patients:a meta-analysis[J].Renal Failure,2024,46(2):2387431.
6
Kim I B,Fealy N,Baldwin I,et al.Premature circuit clotting due to likely mechanical failure during continuous renal replacement therapy[J].Blood Purification,2010,30(2):79-83.
7
查丽玲,周松,江榕.ICU行枸橼酸抗凝CRRT病人非计划性下机影响因素研究[J].护理研究,2018,32(18):2926-2930.
8
Zarbock A,Küllmar M,Kindgen-Milles D,et al.Effect of regional citrate anticoagulation vs systemic heparin anticoagulation during continuous kidney replacement therapy on dialysis filter life span and mortality among critically ill patients with acute kidney injury:a randomized clinical trial[J].JAMA,2020,324(16):1629-1639.
9
Tsujimoto H,Tsujimoto Y,Nakata Y,et al.Pharmacological interventions for preventing clotting of extracorporeal circuits during continuous renal replacement therapy[J].Cochrane Database of Systematic Reviews,2020,3(1):CD012467.
10
Brain M,Winson E,Roodenburg O,et al.Non anti-coagulant factors associated with filter life in continuous renal replacement therapy(CRRT):a systematic review and meta-analysis[J].BMC Nephrology,2017,18(1):69.
11
彭莉,赵振华,蔡雪,等.ICU患者RCA-CRRT非计划下机影响因素的研究进展[J].现代医学,2024,52(8):1294-1298.
12
Murugan R,Hoste E,Mehta R L,et al.Precision fluid management in continuous renal replacement therapy[J].Blood Purification,2016,42(3):266-278.
13
Foglia M J,Pelletier J H,Bayir H,et al.Tandem therapeutic plasma exchange reduces continuous renal replacement therapy downtime[J].Blood Purification,2022,51(6):523-530.
14
Kellum J A,Ronco C.The 17th acute disease quality initiative international consensus conference:introducing precision renal replacement therapy[J].Blood Purification,2016,42(3):221-223.
15
Moons K G M,de Groot J A H,Bouwmeester W,et al.Critical appraisal and data extraction for systematic reviews of prediction modelling studies:the CHARMS checklist[J].PLoS Medicine,2014,11(10):e1001744.
16
Moons K G M,Wolff R F,Riley R D,et al.PROBAST:a tool to assess risk of bias and applicability of prediction model studies:explanation and elaboration[J].Annals of Internal Medicine,2019,170(1):W1-W33.
17
Wang F Z,Zhang R,Tan L,et al.A predictive model for real-time LSTM methods:monitoring dynamic transmembrane pressure improves loop life and anticoagulant therapy accuracy in continuous renal replacement therapy[J].Technology and Health Care,2025,33(5):2305-2319.
18
何淑雅,丁玲玲.老年急性心力衰竭患者连续性肾脏替代治疗非计划性下机的影响因素及预测模型构建[J].中国急救医学,2025,45(7):619-624.
19
刘倩,张明,孙邵婷,等.构建评估连续性肾脏替代治疗抗凝失败风险的列线图模型[J].中国血液净化,2025,24(4):278-282.
20
全梓林,尹燕,崔冬梅,等.基于列线图构建儿童连续性肾脏替代治疗体外循环衰竭预测模型[J].中国血液净化,2025,24(1):13-17.
21
李林莉,杨家慧.重症胰腺炎CRRT治疗患者发生非计划性下机预测模型的建构[J].转化医学杂志,2025,14(3):16-21.
22
蒋丽丽,於环环,陶镜羽,等.连续性肾脏替代治疗非计划性下机的影响因素研究及预测模型构建[J].中西医结合护理(中英文),2025,11(2):157-160.
23
孙媛,顾云雨,黄燕.尿毒症患者应用CRRT时体外循环装置凝血的危险因素及预警模型[J].中国现代医生,2025,63(1):38-42.
24
Chen Z B,Pan L G,Zhang J,et al.Development and validation of a nomogram for circuit lifespan of regional citrate anticoagulation-continuous renal replacement therapy in intensive care patients with acute kidney injury[J].Nursing in Critical Care,2025,30(4):e13196.
25
贾燕,李娜,刘考,等.连续性肾脏替代治疗滤器凝血风险预测模型的构建及验证[J].智慧健康,2024,10(25):68-72.
26
Yang E M,Wang Q H,Guo J,et al.Development and external validation of a prediction model for the premature circuit clotting of continuous renal replacement therapy in critically ill patients[J].Intensive & Critical Care Nursing,2024,84:103703.
27
许红妍,任奇,祝利红,等.连续性肾脏替代治疗非计划下机风险预测模型的构建与外部验证[J].中华危重病急救医学,2024,36(5):520-526.
28
Liu L,Liu D S,He T,et al.Coagulation risk predicting in anticoagulant-free continuous renal replacement therapy[J].Blood Purification,2024,53(11/12):916-927.
29
胡璐璐,牛洪艳,韩小云,等.连续性肾脏替代治疗体外循环装置凝血风险预测模型的构建与验证[J].中华护理杂志,2023,58(15):1845-1851.
30
吴玲玲.脓毒症患者血液净化非计划性下机影响因素分析及风险预测模型构建[D].遵义:遵义医科大学,2023.
31
万娜,于洋,王淑芹,等.ECMO联合应用期间CRRT非计划性下机的预测模型构建[J].护理学杂志,2022,37(12):6-9.
32
常蓉,李玲玲.连续性肾脏替代治疗患者发生管路凝血预测模型的构建[J].临床肾脏病杂志,2022,22(12):1016-1022.
33
Zhang W,Bai M,Zhang L,et al.Development and external validation of a model for predicting sufficient filter lifespan in anticoagulation-free continuous renal replacement therapy patients[J].Blood Purification,2022,51(8):668-678.
34
Kakajiwala A,Jemielita T,Hughes J Z,et al.Membrane pressures predict clotting of pediatric continuous renal replacement therapy circuits[J].Pediatric Nephrology,2017,32(7):1251-1261.
35
Fu X,Liang X L,Song L,et al.Building and validation of a prognostic model for predicting extracorporeal circuit clotting in patients with continuous renal replacement therapy[J].International Urology and Nephrology,2014,46(4):801-807.
36
陈香萍,张奕,庄一渝,等.PROBAST:诊断或预后多因素预测模型研究偏倚风险的评估工具[J].中国循证医学杂志,2020,20(6):737-744.
37
Yang P F,Yang F,Wang Q,et al.Risk prediction models for post-intensive care syndrome of ICU discharged patients:a systematic review[J].International Journal of Nursing Sciences,2025,12(1):81-88.
38
高瑞磊,王丹,戴国华,等.心力衰竭患者出院后再入院风险预测模型的系统评价[J].中国胸心血管外科临床杂志,2025,32(5):677-684.
39
周淼,陈星,彭飞,等.ICU患者中心静脉导管相关血流感染风险预测工具的系统评价[J].中华护理杂志,2025,60(9):1132-1139.
40
Moons K G,Kengne A P,Woodward M,et al.Risk prediction models:I.Development,internal validation,and assessing the incremental value of a new (bio)marker[J].Heart,2012,98(9):683-690.
41
Przybyl H,Androwich I,Evans J.Using high-fidelity simulation to assess knowledge,skills,and attitudes in nurses performing CRRT[J].Nephrology Nursing Journal,2015,42(2):135-147.
2026年第40卷第16期
16
6
引用本文
BibTeX
文章信息
doi: 10.12102/j.issn.1009-6493.2026.16.023
  • 接收时间:2025-09-25
  • 首发时间:2026-10-30
  • 出版时间:2026-08-25
补充材料
相关文章
文章信息
作者
出版历史
  • 收稿日期:2025-09-25
  • 修回日期:2026-07-26
基金
作者信息
    1大连医科大学附属第一医院,辽宁 116011

通讯作者:

康艳楠,E-mail:
KANG Yannan, E-mail:
参考文献
分享链接
https://castjournals.cast.org.cn/joweb/hlyj/CN/10.12102/j.issn.1009-6493.2026.16.023
分享至
全文二维码

扫描看全文

引用本文
BibTeX
本文的引用情况
2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
关闭全屏