综合脱机指数预测机械通气脱机价值的Meta分析

目的采用Meta分析系统评价综合脱机指数（IWI）对机械通气脱机的诊断价值。 方法系统检索PubMed、Web of Science、EMbase、中国知网、万方等数据库，检索时间为各数据库建库至2018年10月。由2人按照设定的纳入与排除标准进行筛选文献，查找相关文献，并采用QUADAS-2对纳入文献进行质量评价，利用Meta-DiSc软件进行数据分析、汇总结果。 结果共纳入5篇文献和783例患者，IWI对有创机械通气脱机的合并诊断价值如下：敏感度为0.95（95%CI：0.90~0.99），特异度为0.81（95%CI：0.68~0.94），阳性似然比为4.46（95%CI：1.98~10.07），阴性似然比为0.08（95%CI：0.03~0.19），诊断比值比为60.34（95%CI：16.54~220.05），综合受试者曲线下面积为0.9466。 结论IWI在有创机械通气脱机的诊断中具有一定的诊断价值，可作为辅助预测脱机的诊断指标。

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

ObjectiveTo investigate the value of integrative weaning index (IWI) on weaning from mechanical ventilation. MethodsThe 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. ResultsFive 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. ConclusionIWI can improve the diagnostic accuracy on weaning from mechanical ventilation.