EuroSCORE II是否仍然是2022年心脏手术死亡率的可靠预测指标? 一个回顾性研究研究回顾性研究
Giorgio Mastroiacovo1, Alice Bonomi2, Monica Ludergnani3
1IRCCS Centro Cardiologico Monzino, Department of Cardiovascular Surgery, Milan, Italy.
概括
风险评估工具EuroSCORE II可能会高估或低估心脏手术患者的死亡率. 这项研究发现,对于高危人群来说,它是不可靠的,特别是在紧急情况下.
科学领域:
- 心脏病学 心脏病学
- 手术风险评估手术风险评估
- 健康 结果 研究 研究 结果
背景情况:
- 欧洲心脏手术风险评估系统II (EuroSCORE II) 是用于心脏手术中术后风险评估的广泛使用的工具.
- 最近的研究质疑其准确性,表明在成人心脏手术中潜在的风险高估.
- 准则建议EuroSCORE II,但其预测性表现需要验证.
研究的目的:
- 为了验证EuroSCORE II对30天住院死亡率的预测准确度.
- 评估EuroSCORE II在开放式心脏手术的高容量中心的可靠性.
- 为了评估不同外科设置 (可选与紧急) 的EuroSCORE II性能.
主要方法:
- 从2016年到2022年,对4034名接受心脏手术的患者进行了回顾性队列研究.
- 使用接收器运行特征 (ROC) 曲线分析 (曲线下的面积 - AUC) 评估EuroSCORE II歧视.
- 校准图被用来评估预测和观察到的死亡率之间的一致性.
主要成果:
- 欧罗斯科尔II对30天死亡率 (AUC = 0.834) 进行了良好的歧视.
- 然而,它高估了低风险选择性手术的死亡率.
- 它大大低估了紧急程序的死亡率,其EuroSCORE II值高于10.
结论:
- EuroSCORE II可能不是心脏手术患者实际死亡风险的可靠预测指标.
- 它的准确性值得怀疑,特别是在高风险患者和紧急干预方面.
- 为了准确的术后风险评估,可能需要进一步细化或替代风险评分.
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