使用风险评分预测感染性内心炎手术后30天死亡率:来自欧洲多中心比较验证研究的见解
Giuseppe Gatti1, Antonio Fiore2, Maria Ismail3
1Department of Cardio-Thoraco-Vascular, University of Trieste, Trieste, Italy.
American heart journal
|June 7, 2024
概括
与特定的IE风险得分相比,EuroSCORE II在感染性内心炎 (IE) 手术后预测早期死亡率方面表现出更好的歧视. 然而,AEPEI II和APORTEI得分为这些高风险的心脏手术提供了更好的校准.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 传染性内心炎研究研究
背景情况:
- 预测感染性内心炎 (IE) 心脏手术后的早期死亡率至关重要.
- 欧洲心脏手术风险评估系统II (EuroSCORE II) 与IE特定风险评分的比较性能仍然不清楚.
研究的目的:
- 为了比较EuroSCORE II的预测准确度与五个已建立的IE特异性风险评分,用于心脏手术后的早期死亡率.
- 在欧洲多中心队列中评估这些风险评分的校准和歧视.
主要方法:
- 在5个欧洲中心对1,012名为确定的IE接受心脏手术的患者的术后数据进行了回顾性分析.
- 使用校准图表和ROC曲线分析对EuroSCORE II与STS-IE,PALSUSE,ANCLA,AEPEI II和APORTEI风险评分进行比较验证.
- 通过曲线下面面积 (AUC) 的比较和30天死亡率预测的协议分析来评估歧视.
主要成果:
- 共进行了1036次心脏手术,30天死亡率为9.7%.
- 所有IE特定的风险分数都显示出比EuroSCORE II更好的校准,其中AEPEI II和APORTEI表现最好.
- 与所有特定IE风险得分 (AUC ≤ 0.693,P ≤ .01) 相比,EuroSCORE II显示出更高的歧视 (AUC 0.751).
结论:
- 欧洲Score II显示,IE手术后30天死亡率的歧视性比已确立的5个IE特异性风险得分更高.
- AEPEI II和APORTEI得分为预测该患者群体的早期死亡率提供了卓越的校准.
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