预测心力衰竭死亡率使用丹麦急性心肌梗塞并发症指数 (DANCAMI)
Usama Sikandar1,2,3, Kasper Bonnesen1,2, Uffe Heide-Jørgensen1,2
1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark.
Acta cardiologica
|May 15, 2025
概括
丹麦急性心肌梗塞并发症指数 (DANCAMI) 有效预测心力衰竭 (HF) 患者的全因死亡率. 虽然它提高了所有原因死亡率的风险预测,但它并没有显著提高HF心血管死亡率的预测.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 生物统计学 生物统计学
背景情况:
- 伴随性疾病在患有充血性心力衰竭 (HF) 的患者中显著增加死亡风险.
- 伴随性疾病指数对于标准化对伴随性疾病负担的评估和预测患者预后至关重要.
- 丹麦急性心肌梗塞并发症指数 (DANCAMI) 是一个经过验证的指数,但其在HF人群中的有用性需要研究.
研究的目的:
- 评估丹麦急性心肌梗塞并发症指数 (DANCAMI) 在被诊断为心力衰竭 (HF) 患者的死亡率预测中的区分能力.
- 为了比较DANCAMI的表现与已建立的并发症指数,即查尔森并发症指数 (CCI) 和Elixhauser并发症指数 (ECI),在HF队列中.
主要方法:
- 一项基于人口的队列研究,包括311,628名在1995年至2020年期间首次诊断出HF的丹麦成年患者.
- 使用后勤回归分析计算30天,1年和10年全因和心血管死亡率的接收器运行特征曲线 (AUC) 下的面积.
- 对模型的AUC进行了比较,仅使用基线人口统计数据 (年龄,性别),并添加DANCAMI,CCI或ECI.
主要成果:
- 在30天 (0.688比0.662),1年 (0.715比0.680) 和10年 (0.840比0.810) 的所有原因死亡率中,DANCAMI显示出比基线模型更高的AUC.
- 对于心血管死亡率,DANCAMI和基线模型之间的AUC在所有时间点之间都是可比的.
- 在所有评估的时间间隔中,CCI和ECI的AUC与DANCAMI在所有原因和心血管死亡率上都相似.
结论:
- 将DANCAMI纳入风险预测模型显著改善了对心力衰竭患者短期和长期全因死亡率的歧视.
- 除了基线人口信息之外,DANCAMI没有为心血管死亡率提供额外的歧视性价值.
- 该研究表明,DANCAMI是评估HF全因死亡风险的有价值工具,其性能与CCI和ECI相美.
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