目的 系统检索和评价维持性血液透析患者的衰弱风险预测模型。 方法 系统检索Web of Science、PubMed、CINAHL、Cochrane Library、Embase、中国知网、维普网、万方数据知识服务平台、中国生物医学文献数据库发表的维持性血液透析患者衰弱风险预测模型的相关文献。检索时限为建库至2024年5月1日。2名研究者根据纳入与排除标准独立进行文献筛选、提取数据、评价模型效能和文献质量。 结果 最终纳入16项研究，共18个模型。6项研究进行了内部验证，1项研究进行了外部验证，1项研究内外部验证相结合，15项研究的区分度均＞0.7。模型适用性普遍较好，但总体偏倚风险较高，主要集中于统计分析领域。出现频率≥5次的预测因子有年龄、合并症、白蛋白、性别、营养、运动训练情况。 结论 现有维持性血液透析患者衰弱风险预测模型多存在方法学缺陷和高偏倚风险，未来应在规范研究设计和报告流程的基础上，构建衰弱风险预测模型并加以内外部验证。
Objective To systematically search and evaluate the frailty risk prediction models for maintenance hemodialysis (MHD) patients. Methods The relevant literatures on frailty risk prediction models for MHD patients published on Web of Science, PubMed, CINAHL, Cochrane Library, Embase, CNKI, Wipnet, Wanfang and Chinese Biomedical Literature Database were systematically searched. The search period is up to May 1, 2024. Two researchers independently screened the literatures according to the inclusion and exclusion criteria, extracted data, evaluated model performance and quality of the literatures. Results A total of 16 studies with 18 models were included. Six studies conducted internal validation, one conducted external validation, and one conducted a combination of internal and external validation. The differentiation of 15 studies was ＞0.7. Models applicability is generally good, but the risk of overall bias is high, and mainly concentrated in the field of statistical analysis. The predictors of frequency ≥5 were age, comorbidities, albumin, sex, nutrition and sports training. Conclusion Most of the existing frailty risk prediction models for MHD patients have methodological defects and higher bias. In the future, frailty risk prediction models should be constructed and verified internally and externally on the basis of standardized research design and reporting procedures.
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