在初级保健中SCORE2模型低估了心血管风险:呼吁重新校准
V M I Voorbrood1, A M Bohnen1, A P Bosman1
1Erasmus MC, University Medical Center, Rotterdam, Department of General Practice.
European journal of preventive cardiology
|April 26, 2025
概括
SCORE2模型低估了初级保健中的心血管疾病 (CVD) 风险. 观察到的心血管疾病风险为10.1%,明显高于预测的6.2%,可能会推迟预防性治疗.
科学领域:
- 心血管流行病学心血管流行病学
- 风险预测建模风险预测建模
- 初级护理研究初级护理研究
背景情况:
- SCORE2模型估计了心血管事件 (CVE) 风险,用于初级保健使用.
- 它指导了日常实践中首次出现的CVE的治疗决策.
研究的目的:
- 评估SCORE2模型在预测荷兰初级保健中首发性CVE的准确性.
- 在患者随访期间,比较观察到的CVE风险与SCORE2预测的风险.
主要方法:
- 对205,548名成年患者进行了回顾性队列研究.
- 分析包括年龄,性别,吸烟,糖尿病,胆固醇和血压.
- 使用O/E比率,校准图表和C统计数据评估模型性能,按人口统计和风险类别分层.
主要成果:
- 观察到的10年CVE风险为10.1%,超过预测的6.2% (O/E比率:1.54-1.68).
- 在各个年龄组 (<50岁和≥50岁) 和性别中观察到低估.
- 估计有35%的患者可能因SCORE2的低估而错过了预防性治疗.
结论:
- SCORE2模型似乎低估了初级保健机构中CVE风险.
- 建议对SCORE2模型进行校准,以准确评估初级保健中的风险.
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