针对透析患者的EuroSCORE II验证研究:日本的一项单中心研究
Keishiro Sueda1, Eiji Hiraoka1, Koichi Kitamura2
1Department of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan.
Journal of cardiology
|October 6, 2023
概括
欧洲SCORE II模型准确地预测了低风险透析患者的心脏手术死亡率,但低估了高风险组的风险. 在这个人群中,它对医院死亡的歧视表现很好.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 医学统计 医学统计
背景情况:
- 欧洲心脏手术风险评估系统 (EuroSCORE II) 是预测心脏手术后住院死亡率的标准工具.
- 透析患者心脏手术后死亡率较高,因此需要对该人群中现有的风险模型进行验证.
- 之前,EuroSCORE II尚未在接受心脏手术的维持透析患者中得到验证.
研究的目的:
- 评估EuroSCORE II模型对接受心脏手术的维持透析患者住院死亡率的预测性能.
- 评估EuroSCORE II在预测高风险群体的结果中的校准和歧视.
主要方法:
- 一项回顾性,单中心研究包括163名接受开放心脏手术的成年维持透析患者.
- 通过比较低 (<4%),中等 (4-8%) 和高 (>8%) EuroSCORE II 风险组的预期与观察到的死亡率来评估校准.
- 使用接收器操作特征曲线 (AUROC) 下面的面积来评估歧视.
主要成果:
- 整体住院死亡率为9.2%.
- 观察到的死亡率为低风险组的2.1% (预计2.4%),中等风险组的7.5% (预计5.5%),高风险组的34.5% (预计21.1%).
- 在医院死亡的AUROC为0.825,表明良好的歧视.
结论:
- EuroSCORE II 充分估计了低风险和中等风险透析患者的住院死亡率 (EuroSCORE II <8%).
- 该模型低估了维持透析患者的高风险组 (EuroSCORE II>8%) 的住院死亡率.
- 在这个特定的患者群体中,EuroSCORE II在医院死亡方面表现良好.
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