摘要
目的评估EumSCORE对冠状动脉旁路移植术（CABG）患者术后早期死亡的预测价值。方法2005年1月至2007年12月，共有310例患者接受CABG，收集患者的临床资料，包括EuroSCORE全部17项危险因子的详细数据，并进行评分。按预测病死率值的范围将所有患者分为低危组（0～2分）、中危组（3～5分）、高危组（6—13分），对每组的预测病死率和实际病死率进行对比研究。利用接受者工作特征（ROC）曲线评价EuroSCORE的预测价值及准确性。结果术前危险评分，低危组患者占25．2％（78／310），中危组患者占48．4％（150／310），高危组患者占26．4％（82／310）。预测病死率低危组1．4％，中危组2．7％，高危组7．4％；实际病死率三组分别为0、1．3％和3．7％。预测总病死率为3．6％，实际总病死率为1．6％。预测病死率和实际病死率之间有较好的一致性。ROC曲线下面积计算结果，整组患者为0．78，预测价值为中等。分组计算，非体外循环组为0．82，心肺转流组和合并瓣膜手术组为0．66，显示对其预测价值较低。结论EuroSCORE对CABG患者预后有较好的预测价值，尤其是非体外循环手术患者。
Objective To verify the predictive value of EuroSCORE of early mortality in coronary artery bypass grafting （CABG） patients. Method From January 2005 to March 2007, 310 consecutive patients were operated with CABG. Detailed data for the EuroSCORE risk factor were collected and all patients were scored according to the EuroSCORE additive model, retrospectively or prospectively. Expected or predicted mortality was calculated for individual patients using the EuroSCORE algorithms, arranged sequentially in order of predicted score. The population was divided into three clinically relevant risk categories according to the range of predicted mortality rate. Expected mortality was compared to observed or actual mortality for each risk category. Mortality was defined as death from any cause within 30 days of operation or within the same hospital admission. Results Preoperative overall patients： low-risk group was 25.2% （78/310）, middle-risk group was 48.4% （ 150/310）, high-risk group was 26.4% （82/310）. In the EuroSCORE model, predicted mortality was 1.4% for low-risk group, 2. 7% for middle-risk group, 7.4% for high-risk group, and 3.6% for overall patients. Actual mortality was 0, 1.3% and 3.7% respectively, overall early mortality was 1.6%. Area under the ROC curve was 0. 78. Conclusion The EuroSCORE yield good predictive value for hospital mortality of patients undergoing CABG, especially in offpump CABG.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2009年第8期583-585,共3页
Chinese Journal of Surgery
