在急性肺栓塞中,GRACE风险评分可以预测死亡率和需要进行血栓溶解治疗吗?
Esra Dönmez1, Sevgi Özcan1, İrfan Sahin1
1Department of Cardiology, Bağcılar Training and Research Hospital, Bağcılar, İstanbul, Turkey.
The American journal of cardiology
|November 3, 2023
概括
全球急性冠状动脉事件注册 (GRACE) 风险评分有效预测急性肺栓塞 (PE) 患者的30天死亡率. 高GRACE分数表明PE死亡风险增加,有助于预后评估.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 临床风险分层的临床风险分层
背景情况:
- 急性冠状动脉综合征和肺栓塞 (PE) 分享重叠的临床表现和危险因素.
- 风险评分对于评估两种情况的疾病严重程度至关重要.
- 全球急性冠状动脉事件注册表 (GRACE) 风险评分在PE管理中的实用性需要进一步评估.
研究的目的:
- 评估GRACE风险评分对急性PE患者30天死亡率的预测能力.
- 为了确定GRACE得分是否可以预测急性PE中需要进行血栓抑制治疗.
- 为了比较GRACE和肺栓塞严重性指数 (PESI) 评分的预测性能.
主要方法:
- 在2018年1月至2022年5月期间,对197名急性PE住院患者进行了回顾性研究.
- 在入院时使用临床,心电图和实验室数据计算GRACE和PESI风险得分.
- 对30天死亡率和对血栓溶解治疗的需求的分析.
主要成果:
- 30天死亡率为28.4%;32.5%的患者需要进行血栓治疗.
- 无论是GRACE和PESI分数都是30天死亡率和需要进行血栓溶解的独立预测指标.
- 一个GRACE分数切断值为160.5,显示了88.5%的灵敏度和89.4%的特异性,用于预测30天死亡率.
结论:
- GRACE风险评分是预测急性PE早期死亡率的强大工具.
- 较高的GRACE分数与短期PE相关死亡率的增加显著相关.
- 结合GRACE和PESI分数可以提高高风险PE患者的识别和预后预测.
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