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在CRISP注册表中的T案例类型风险类别中,PREDIC的有用性3
Daisuke Kobayashi1, Elena K Amin2, Gareth J Morgan3
1Division of Cardiology, Department of Pediatrics, St. Louis Children's Hospital / Washington University School of Medicine, St. Louis, Missouri.
在先天性心脏导管治疗中的程序风险 (PREDIC3T) 度量有效预测儿科心脏导管治疗中的重大不良事件 (SAE). 这种风险分类工具在大型注册表分析中显示出与标记企业的强烈关联.
科学领域:
- 心脏病学 心脏病学
- 儿科干预心脏病学
- 医疗信息学 医疗信息学
背景情况:
- 产生的先天性心脏导管项目 (C3PO) 注册表引入了先天性心脏导管中的程序性风险 (PREDIC3T) 度量.
- 在此之前,PREDIC3T指标在独立数据集中的临床实用性和验证尚未评估.
研究的目的:
- 评估PREDIC3T风险类别与重大不良事件 (SAE) 发生之间的关联.
- 在现实环境中评估PREDIC3T指标作为程序性风险分类工具.
主要方法:
- 从2009年到2022年对先天性心血管干预研究联盟 (CCISC) 注册表数据的分析.
- 将59,822个病例分配到6个PREDIC3T风险类别,并评估SAE率.
- 使用后勤回归模型来评估PREDIC3T类别与SAE之间的关联,并对共变量进行调整. 模型歧视是使用c-statistic进行评估的.
主要成果:
- 总共有64,419个案例被分析,其中93%被分配到PREDIC3T类别.
- 在PREDIC3T类别中,SAE率逐渐增加,从0类别的1.0%增加到5类别的9.0%.
- 在多变量分析中,PREDIC3T类别与SAE风险显著相关 (p <0.001),调整后的c-统计值为0.707.
结论:
- PREDIC3T风险类别与先天性心脏导管术过程中的SAE风险有显著的关联.
- PREDIC3T指标似乎是一个有价值的工具,用于分类在儿科心脏导管治疗过程中的手术风险.
- 这项验证支持使用PREDIC3T进行风险分层和在先天性心脏病干预中改善质量的举措.
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