Diagnosis accuracy of integrative weaning index for weaning from mechanical ventilation: A Meta-analysis

doi:10.3877/cma.j.issn.2096-1537.2019.03.008

Abstract

Abstract:

Objective

To investigate the value of integrative weaning index (IWI) on weaning from mechanical ventilation.

Methods

The PubMed, Web of Science, EMbase, CNKI, WangFang Databases were searched for IWI diagnostic accuracy on weaning from mechanical ventilation up to October 2018. Two reviewers independently screened the literatures based on the inclusion and exclusion criteria. The methodological quality of included studies was assessed by QUADAS-2. Data were analyzed by Meta-DiSc software.

Results

Five studies involving 783 patients were included. The summary estimates for IWI diagnostic accuracy on weaning from mechanical ventilation included: sensitivity 0.95 (95%CI: 0.90-0.99), specificity 0.81 (95%CI: 0.68-0.94), positive likelihood ratio 4.46 (95%CI: 1.98~10.07), negative likelihood ratio 0.08 (95%CI: 0.03-0.19), diagnosis odds ratio 60.34 (95%CI: 16.54-220.05), and the area under the curve of SROC was 0.9466.

Conclusion

IWI can improve the diagnostic accuracy on weaning from mechanical ventilation.

Key words: Integrative weaning indexl, Mechanical ventilation, Weaning, Meta-analysis

Bin Zhang, Wei Cao, Xiu Wu, Yun′an Liu, Yuan Zhao, Qingqing Zhang, Shengyu Wang. Diagnosis accuracy of integrative weaning index for weaning from mechanical ventilation: A Meta-analysis[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2019, 05(03): 243-248.

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URL: https://icu.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2096-1537.2019.03.008

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Figures/Tables 8

References 22

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第一作者	时间	国家	年龄（岁，±s）	男/女（例）	病例数	研究类型
Nemer^[10]	2009	巴西	64.20±17.32	NR	331	前瞻随机对照
El-Baradey^[17]	2015	印度	41.75±12.42	63/57	120	前瞻双盲随机对照研究
de Souza^[18]	2015	巴西	61±20	58/45	103	前瞻性研究
Ebrahimabadi^[19]	2017	伊朗	46.86±2.69	70/35	105	前瞻性研究
Madani^[20]	2013	伊朗	61.56±20.86	86/38	124	前瞻单盲对照多中心

第一作者	时间	国家	年龄（岁，±s）	男/女（例）	病例数	研究类型
Nemer^[10]	2009	巴西	64.20±17.32	NR	331	前瞻随机对照
El-Baradey^[17]	2015	印度	41.75±12.42	63/57	120	前瞻双盲随机对照研究
de Souza^[18]	2015	巴西	61±20	58/45	103	前瞻性研究
Ebrahimabadi^[19]	2017	伊朗	46.86±2.69	70/35	105	前瞻性研究
Madani^[20]	2013	伊朗	61.56±20.86	86/38	124	前瞻单盲对照多中心

第一作者	AUC（95% CI）	PSV模式			TP	FP	FN	TN	敏感度	特异度
第一作者	AUC（95% CI）	PS（cmH₂O）	PEEP（cmH₂O）	FiO₂（%）	TP	FP	FN	TN	敏感度	特异度
Nemer^[10]	0.96（0.94~0.98）	8~10	5	35	269	3	8	51	0.97	0.94
El-Baradey^[17]	NR	NR	5	40	85	7	2	26	0.97	0.78
de Souza^[18]	0.86（0.82~0.90）	8	5	40	50	9	10	34	0.83	0.78
Ebrahimabadi^[19]	0.41（NR）	8~10	5	<40	86	9	4	6	0.96	0.40
Madani^[20]	0.97（0.90~0.99）	8~10	5	≤40	72	8	8	36	0.90	0.82

第一作者	AUC（95% CI）	PSV模式			TP	FP	FN	TN	敏感度	特异度
第一作者	AUC（95% CI）	PS（cmH₂O）	PEEP（cmH₂O）	FiO₂（%）	TP	FP	FN	TN	敏感度	特异度
Nemer^[10]	0.96（0.94~0.98）	8~10	5	35	269	3	8	51	0.97	0.94
El-Baradey^[17]	NR	NR	5	40	85	7	2	26	0.97	0.78
de Souza^[18]	0.86（0.82~0.90）	8	5	40	50	9	10	34	0.83	0.78
Ebrahimabadi^[19]	0.41（NR）	8~10	5	<40	86	9	4	6	0.96	0.40
Madani^[20]	0.97（0.90~0.99）	8~10	5	≤40	72	8	8	36	0.90	0.82

纳入指标		敏感度（95% CI）	特异度（95% CI）	PLR（95% CI）	NLR（95% CI）	DOR（95% CI）
地域		?	?	?	?	?
?	亚洲	0.946（0.910~0.970）	0.739（0.637~0.825）	3.228（1.324~7.867）	0.085（0.038~0.191）	42.711（12.729~143.320）
?	南美洲	0.947（0.917~0.968）	0.876（0.794~0.934）	7.915（1.397~44.842）	0.081（0.012~0.539）	100.600（3.560~2842.500）
年龄（岁）		?	?	?	?	?
?	<60	0.966（0.928~0.987）	0.667（0.516~0.796）	2.642（0.812~8.599）	0.060（0.014~0.256）	46.114（4.233~502.390）
?	≥60	0.938（0.910~0.959）	0.858（0.789~0.911）	6.282（2.777~14.211）	0.093（0.030~0.287）	72.053（11.344~457.670）

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