Izole kafa travmalarında prognoz tahmininde geliştirilen modellerin etkinliğinin değerlendirilmesi
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Dosyalar
Tarih
2013
Yazarlar
Dergi Başlığı
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmada, Trakya Üniversitesi Hastanesine yatırılan izole kafa travmalı olgularda prognoz tahmininde geliştirilmiş modellerin etkinliğinin değerlendirilmesi amaçlandı. Trakya Üniversitesi Hastanesi Beyin ve Sinir Cerrahisi Anabilm Dalı ve Yoğun Bakım Ünitelerine yatırılan 204 kafa travmalı olgunun kayıtları incelendi. Elde edilen veriler kullanılarak modeller uygulandı ve prognoz tahminleri elde edildi. Modellerin prognoz tahminleri ve olguların gerçek klinik sonuçları dizkriminant analizi ile istatistiksel olarak incelendi. Model 1?in doğru sınıflandırma oranının % 87,9 olduğu saptandı. Model 1?in özgüllüğü (sensitivite) % 66,7, duyarlılığı (spesifite) % 94,2, pozitif prediktif değeri % 68,8, negatif prediktif değeri % 93,6 olarak saptandı. Model 2?nin doğru sınıflandırma oranının % 90,2 olduğu saptandı. Model 2'nin özgüllüğü (sensitivite) % 57,6, duyarlılığı (spesifite) % 96,5, pozitif prediktif değeri % 76, negatif prediktif değeri % 92,2 olarak saptandı. Sonuç olarak, modellerin etkin tahmin araçları olduğu ve bu modellerin kullanımının izole kafa travmalı olgularda ölüm ve kalıcı bitkisel durum tahmininde yararlı olacağı saptandı. Çok merkezli ulusal ve uluslar arası çalışmalarla modellerin geçerliliğinin değerlendirilmesi ile modellerin yaygın olarak kullanılmaya aday ölçütler olduğu saptandı.
Abstract
The aim of this study is to evaluate two predictive models for prognosis on isolated head injured patients. The records of 204 isolated head injured patients hospitalized in Trakya University Hospital, Department of Neurosurgery and Intensive Care Unit have been examined. Using the obtained data, two models were executed and the estimated prognoses were noted. The estimated prognoses data has been statistically analyzed and compared with the real outcomes of the patients by discriminates analysis. Model 1 had a classification ratio of 87,9%, a sensitivity of 66,7%, a specificity of 94,2%, a positive predictive value of 68,8% and a negative predictive value of 93,6%. Model 2 had a classification ratio of 90,2%, sensitivity of 57,6%, a specificity of 96,5%, a positive predictive value of 76%, and a negative predictive value of 92,2. As a conclusion, both models have been evaluated as effective tools for predicting outcome and it is concluded that their use as prognostic models could be beneficial for predicting death and persistent vegetative state. It has have been concluded that both models has potential to be a widely usable predicting tool after that they are evaluated by multicenter national and international trials.
Abstract
The aim of this study is to evaluate two predictive models for prognosis on isolated head injured patients. The records of 204 isolated head injured patients hospitalized in Trakya University Hospital, Department of Neurosurgery and Intensive Care Unit have been examined. Using the obtained data, two models were executed and the estimated prognoses were noted. The estimated prognoses data has been statistically analyzed and compared with the real outcomes of the patients by discriminates analysis. Model 1 had a classification ratio of 87,9%, a sensitivity of 66,7%, a specificity of 94,2%, a positive predictive value of 68,8% and a negative predictive value of 93,6%. Model 2 had a classification ratio of 90,2%, sensitivity of 57,6%, a specificity of 96,5%, a positive predictive value of 76%, and a negative predictive value of 92,2. As a conclusion, both models have been evaluated as effective tools for predicting outcome and it is concluded that their use as prognostic models could be beneficial for predicting death and persistent vegetative state. It has have been concluded that both models has potential to be a widely usable predicting tool after that they are evaluated by multicenter national and international trials.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Kafa Travması, Head Trauma, Prognoz Tahmini, Prognosis, Outcome
