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对先天性心脏手术的外科风险得分对于长期风险预测是有用的

Andrew Dailey-Schwartz¹, Krisy Kuo², Yanxu Yang²

¹Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA.

Cardiology in the young

|January 17, 2025

概括

现有的评分系统准确地预测了小儿心脏手术后的早期死亡率,但对长期生存的准确性却在下降. 需要新的工具来更好地预测先天性心脏病患者的长期结果.

科学领域:

儿童心脏病学儿童心脏病学
心脏外科手术的结果
生物统计学生物统计学

背景情况:

胸腔外科医生协会-欧洲心胸外科协会 (STAT) 和先天性心脏外科风险调整分类 (RACHS) 评分系统是为预测儿科心脏外科手术中早期死亡率而建立的.
然而,它们在预测这些手术后的长期死亡率方面的有效性仍未得到审查.

研究的目的:

评估STAT,STAT 2020,RACHS-1和RACHS-2评分系统在进行先天性心脏手术的儿科患者中预测早期和长期死亡率的能力.

主要方法:

一项回顾性队列研究利用了儿科心脏护理联盟 (1982-2011) 的数据.
应用了STAT,STAT 2020,RACHS-1和RACHS-2得分来预测早期死亡率和长期生存率.
通过将患者数据与2021年全国死亡指数联系起来,确定了长期结果.

主要成果:

所有评分系统都在预测早期术后死亡率方面表现良好 (c-统计从0.7668到0.7872不等).
对于长期死亡率预测,区分能力下降,c-统计数据从0.6741到0.7156.
STAT 2020和RACHS-2显示了对长期死亡率的最高预测能力.

结论:

对于先天性心脏手术,目前的风险调整得分系统保持了足够的,但降低了预测长期死亡率的准确性.
进一步开发预测工具是必要的,以改善对这种患者群体的长期存活率的评估.

关键词:

的 CHDs 的使用.儿童的健康问题死亡率死亡率研究结果研究成果.

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