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选择正确的工具:在中等风险肺栓塞中比较风险分层模型
Robert S Zhang1, Eugene Yuriditsky2, Peter Zhang3
1Division of Cardiology, Weill Cornell Medicine, New York, New York, USA.
概括
复合PE冲击 (CPES) 评分最好预测中等风险肺栓塞 (PE) 患者的不良结果. 与其他风险分层工具相比,CPES表现优越,支持其临床整合,以改善患者护理.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 临床风险分层的临床风险分层
背景情况:
- 指南建议对中等风险的肺栓塞 (PE) 进行风险分层.
- 缺乏对现有的风险分层工具进行对比.
- 这项研究解决了对比性绩效数据的需求.
研究的目的:
- 为了比较四个风险分层分数的预测性能.
- 评估预测中等风险PE患者不良临床事件的得分.
主要方法:
- 对192名中等风险PE患者的回顾性研究 (2016年10月 - 2019年7月).
- 比较复合PE冲击 (CPES),Bova,简化PE冲击指数 (sPESI),国家早期预警得分 (NEWS) 和ESC中等风险子类别.
- 使用的接收器操作员特征 (ROC) 曲线,以评估与PE相关的死亡率,心脏骤停或血液动力失补偿的复合结果的预测性表现.
主要成果:
- 主要综合结局发生在14.6%的患者中.
- 对于复合结果及其组件,CPES显示了最高的歧视力 (AUC:0.74;95% CI:0.66-0.83).
- 在ESC中等风险子类别中,预测性表现最低 (AUC:0.59;95% CI:0.51-0.68).
结论:
- 在预测中等风险PE的不良结果方面,CPES得分明显优于其他评估工具.
- 这些发现支持CPES的临床整合,以加强患者选择和及时干预.
- CPES可以改善对需要升级护理的PE患者的管理策略.
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