在术后心脏手术患者中对冲击严重性的系统评估
Tobias Roeschl1, Nils Hinrichs1, Matthias Hommel2
1Deutsches Herzzentrum der Charité (DHZC), Department of Cardiothoracic and Vascular Surgery, Berlin, Germany; Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Charité-Universitätsmedizin Berlin, Institute of Medical Informatics, Berlin, Germany.
Journal of the American College of Cardiology
|October 18, 2023
概括
心血管血管图谱与干预学会 (SCAI) 的冲击分类有效预测心脏手术患者的死亡率和并发症. 纳入晚期恶化进一步改善了风险评估,以便更好地对患者进行分拣和研究选择.
科学领域:
- 心脏病学 心脏病学
- 密集护理医学 密集护理医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 心血管血管血管学会和干预 (SCAI) 冲击分类是对心血管患者死亡风险分层的验证工具.
- 它在术后心脏手术重症监护室 (CSICU) 患者的特定环境中的实用性需要进一步评估.
研究的目的:
- 评估SCAI冲击分类在术后CSICU患者中分层风险的有效性.
- 调查晚期恶化 (LD) 作为这一群体中额外的风险修饰因素的影响.
主要方法:
- 从2012年至2022年间,对26792例术后CSICU住院病人的回顾性分析.
- 使用电子健康记录数据将患者分为SCAI冲击阶段A-E.
- 评估SCAI冲击阶段,LD和医院死亡率,并发症和器官功能障碍之间的关联.
主要成果:
- 在SCAI冲击阶段A-E (0.4%至30.2%) 中,医院死亡率显著增加.
- 更高的SCAI冲击阶段和LD的存在独立地与增加的医院死亡率相关 (aOR:分别为1.26-16.59和8.2).
- 在SCAI冲击分类中,死亡率 (AUROC:0.84) 的诊断性能强,并得到了LD (AUROC:0.90) 的增强.
结论:
- 在风险分层中,SCAI冲击分类对术后CSICU患者的死亡率,并发症和器官功能障碍的风险分层有效.
- 这种分类可以作为术后心脏手术护理中的一个有价值的分类工具,以及研究参与者选择的标准.
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