对REMEMBER分数的外部验证
Armin Darius Peivandi1, Henryk Welp1, Sebastian Kintrup2
1Department of Cardiothoracic Surgery, University Hospital Muenster, Muenster, Germany.
Frontiers in cardiovascular medicine
|August 14, 2023
概括
旨在预测冠状动脉绕道移植 (CABG) 后死亡率的REMEMBER评分与静脉外体膜氧化 (VA-ECMO) 显示在外部验证中表现不佳. 这一分数不适用于预测该患者群体的住院死亡率.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 关键护理医学 关键护理医学
背景情况:
- 在冠状动脉旁路移植 (CABG) 后使用静脉外体膜氧化 (VA-ECMO) 与高住院死亡率有关.
- REMEMBER评分是为了预测需要VA-ECMO的CABG患者的住院死亡率而开发的.
研究的目的:
- 在接受VA-ECMO的CABG患者的一个不同的队列中,对REMEMBER得分的预测性能的外部验证.
- 评估REMEMBER得分在预测住院死亡率方面的准确性.
主要方法:
- 在2012年至2021年期间接受VA-ECMO的107名CABG患者的回顾性分析.
- 使用一致性统计和ROC曲线分析评估REMEMBER分数的区分能力.
- 使用大尺度校准和校准斜率对校准的评估.
主要成果:
- 该研究包括107名患者,住院死亡率为45.8%.
- 在REMEMBER分数中,分辨能力低 (AUC:0.623) 和校准不佳 (截面p=0.0195,斜率p=0.0303).
- 通过REMEMBER得分预测的死亡率中位数为52%,与观察到的死亡率不同.
结论:
- 发现REMEMBER得分不准确,不适用于预测VA-ECMO治疗的CABG患者的住院死亡率.
- 建议进行进一步的外部验证研究,最好是在多中心环境中进行,以证实这些发现.
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