术前风险评估系统 (SURPAS) 在广泛的老年 (65岁或以上) 患者群体中的准确性
Haaris Kadri1, Ahmad M Hider1, William G Henderson2
1Surgical Outcomes and Applied Research Program, Department of Surgery, University of Colorado School of Medicine, Aurora, CO.
Surgery
|October 6, 2025
概括
手术风险手术前评估系统在预测老年人手术后并发症方面显示出临床上可接受的准确性,尽管略低于年轻患者的精度. 这种工具有助于老年外科病人的知情决策.
科学领域:
- 老年人手术是一门老年手术.
- 手术结果研究研究.
- 医疗信息学 医疗信息学
背景情况:
- 老年人经历了更高的术后并发症率,需要准确的风险评估.
- 手术前风险评估系统 (SR-PAS) 是一种普遍的风险计算器,在老年人群中缺乏先前验证.
- 评估老年患者的SR-PAS性能对于改善外科护理至关重要.
研究的目的:
- 评估手术风险手术前评估系统 (SR-PAS) 在预测老年患者手术后并发症方面的准确性.
- 为了比较SR-PAS在老年和年轻患者队列中的表现.
主要方法:
- 利用美国外科医生学院2009-2020年国家外科质量改进计划 (NSQIP) 的数据.
- 开发并测试了使用关键临床变量逻辑回归的SR-PAS模型.
- 通过使用C指数,布里尔分数和霍斯默-莱梅斯肖校准图表来评估模型性能.
主要成果:
- 在SR-PAS中,老年患者的C指数为0.800,而年轻患者的C指数为0.846.
- 在老年人群中,12种并发症中的11种中,模型准确度为良好至公平 (C指数≥0.70).
- 在各年龄组之间观察到略高的布赖尔分数 (0.036对0.019) 和良好的校准.
结论:
- 手术风险预手术评估系统对老年手术患者表现出临床上可接受的性能.
- 虽然SR-PAS的准确性略低于年轻人,但它仍然是老年人风险分层的一个有价值的工具.
- 研究结果支持使用SR-PAS来为老年人做出手术决策.
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