目的评价Logistic Euro SCORE与Euro SCOREⅡ风险预测模型对本中心成人单纯二尖瓣置换术后在院死亡率预测的准确性。方法回顾性收集2009年1月至2013年12月497例患者在院接受单纯二尖瓣置换术的临床资料,包括同期行三尖瓣成形、左房减容...目的评价Logistic Euro SCORE与Euro SCOREⅡ风险预测模型对本中心成人单纯二尖瓣置换术后在院死亡率预测的准确性。方法回顾性收集2009年1月至2013年12月497例患者在院接受单纯二尖瓣置换术的临床资料,包括同期行三尖瓣成形、左房减容、左心耳闭合术患者。其中男性186例,女性311例,平均(53.19±11.11)岁。按照第一版的Logistic Euro SCORE模型与新版的Euro SCOREⅡ模型给予评分获得患者的预测死亡率,与患者的实际在院死亡率比较。模型预测的符合程度应用Hosmer-Lemeshow拟和优度检验,而预测的鉴别效度则通过受试者工作特征曲线(ROC)下面积反映。结果497例患者在院死亡6例,全组实际在院死亡率为1.21%,logistic Euro SCORE及Euro SCOREⅡ预测的在院死亡率分别为2.99%和1.53%。其中Euro SCOREⅡ对全组患者在院死亡率预测符合程度较高,而logistic Euro SCORE明显高估了在院死亡率。logistic Euro SCORE的区分度及校准度差(P=0.673,AUC=0.621),Euro SCOREⅡ区分度及校准度均较好(P=0.894,AUC=0.793)。结论 Euro SCOREⅡ对本中心单纯二尖瓣置换手术患者在院死亡风险预测的准确性较高。展开更多
随着现心血管外科中高危病人的比例明显增加。心血管外科医师需要量化的评估体系对患者围手术期危险性进行术前评估。目前国际影响较大的风险预测模型是欧洲心血管手术危险因素评分系统(European system for cardiac operative risk eva...随着现心血管外科中高危病人的比例明显增加。心血管外科医师需要量化的评估体系对患者围手术期危险性进行术前评估。目前国际影响较大的风险预测模型是欧洲心血管手术危险因素评分系统(European system for cardiac operative risk evaluation,EuroSCORE)。中国心血管外科注册登记研究的数据表明,EuroSCORE不能很好地预测我国心血管外科患者的手术风险。因此,中国心血管外科注册登记研究协作组应用最新的心血管外科病例数据建立我国首个冠状动脉旁路移植手术风险评估系统(Sinosystem for coronary operative risk evaluation,SinoSCORE),目前正广泛应用于临床。我们结合文献对EuroSCORE和SinoSCORE两个指标在预测成人心脏病术后死亡率中的应用进行回顾和展望。展开更多
AIM: To investigate the patient characteristics, relationship between the Logistic EuroSCORE (LES) and the observed outcomes in octogenarians who underwent surgical aortic valve replacement (AVR). METHODS: Two hundred...AIM: To investigate the patient characteristics, relationship between the Logistic EuroSCORE (LES) and the observed outcomes in octogenarians who underwent surgical aortic valve replacement (AVR). METHODS: Two hundred and seventy three octogenarians underwent AVR between 1996 and 2008 at Bristol Royal Inf irmary. Demographics, acute outcomes,length of hospital stay and mortality were obtained. The LES was calculated to characterize the predicted operative risk. Two groups were def ined: LES ≥ 15 (n = 80) and LES < 15 (n = 193). RESULTS: In patients with LES ≥ 15, 30 d mortality was 14% (95% CI: 7%-23%) compared with 4% (95% CI: 2%-8%) in the LES < 15 group (P < 0.007). Despite the increase in number of operations from 1996 to 2008, the average LES did not change. Only 5% of patients had prior bypass surgery. The LES identifi ed a low risk quartile of patients with a very low mortality (4%, n = 8, P < 0.007) at 30 d. The overall surgical results for octogenarians were excellent. The low risk group had an excellent outcome and the high risk group had a poor outcome after surgical AVR. CONCLUSION: It may be better treated with transcatheter aortic valve implantation.展开更多
文摘目的评价Logistic Euro SCORE与Euro SCOREⅡ风险预测模型对本中心成人单纯二尖瓣置换术后在院死亡率预测的准确性。方法回顾性收集2009年1月至2013年12月497例患者在院接受单纯二尖瓣置换术的临床资料,包括同期行三尖瓣成形、左房减容、左心耳闭合术患者。其中男性186例,女性311例,平均(53.19±11.11)岁。按照第一版的Logistic Euro SCORE模型与新版的Euro SCOREⅡ模型给予评分获得患者的预测死亡率,与患者的实际在院死亡率比较。模型预测的符合程度应用Hosmer-Lemeshow拟和优度检验,而预测的鉴别效度则通过受试者工作特征曲线(ROC)下面积反映。结果497例患者在院死亡6例,全组实际在院死亡率为1.21%,logistic Euro SCORE及Euro SCOREⅡ预测的在院死亡率分别为2.99%和1.53%。其中Euro SCOREⅡ对全组患者在院死亡率预测符合程度较高,而logistic Euro SCORE明显高估了在院死亡率。logistic Euro SCORE的区分度及校准度差(P=0.673,AUC=0.621),Euro SCOREⅡ区分度及校准度均较好(P=0.894,AUC=0.793)。结论 Euro SCOREⅡ对本中心单纯二尖瓣置换手术患者在院死亡风险预测的准确性较高。
文摘随着现心血管外科中高危病人的比例明显增加。心血管外科医师需要量化的评估体系对患者围手术期危险性进行术前评估。目前国际影响较大的风险预测模型是欧洲心血管手术危险因素评分系统(European system for cardiac operative risk evaluation,EuroSCORE)。中国心血管外科注册登记研究的数据表明,EuroSCORE不能很好地预测我国心血管外科患者的手术风险。因此,中国心血管外科注册登记研究协作组应用最新的心血管外科病例数据建立我国首个冠状动脉旁路移植手术风险评估系统(Sinosystem for coronary operative risk evaluation,SinoSCORE),目前正广泛应用于临床。我们结合文献对EuroSCORE和SinoSCORE两个指标在预测成人心脏病术后死亡率中的应用进行回顾和展望。
文摘AIM: To investigate the patient characteristics, relationship between the Logistic EuroSCORE (LES) and the observed outcomes in octogenarians who underwent surgical aortic valve replacement (AVR). METHODS: Two hundred and seventy three octogenarians underwent AVR between 1996 and 2008 at Bristol Royal Inf irmary. Demographics, acute outcomes,length of hospital stay and mortality were obtained. The LES was calculated to characterize the predicted operative risk. Two groups were def ined: LES ≥ 15 (n = 80) and LES < 15 (n = 193). RESULTS: In patients with LES ≥ 15, 30 d mortality was 14% (95% CI: 7%-23%) compared with 4% (95% CI: 2%-8%) in the LES < 15 group (P < 0.007). Despite the increase in number of operations from 1996 to 2008, the average LES did not change. Only 5% of patients had prior bypass surgery. The LES identifi ed a low risk quartile of patients with a very low mortality (4%, n = 8, P < 0.007) at 30 d. The overall surgical results for octogenarians were excellent. The low risk group had an excellent outcome and the high risk group had a poor outcome after surgical AVR. CONCLUSION: It may be better treated with transcatheter aortic valve implantation.
