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在多中心的新西兰人口中验证了三种评分系统,用于预测破裂腹腔大动脉动脉瘤修复后的死亡率

Jhanvi Dholakia¹, Anantha Narayanan², Philip Allan¹

¹Department of Vascular Surgery, Waikato Hospital, Hamilton, New Zealand.

Annals of vascular surgery

|October 8, 2025

概括

哈伯维尤风险评分 (HRS) 最好预测腹腔大动脉动脉瘤破裂 (rAAA) 患者的30天死亡率. 这一分数有助于对rAAA管理的临床决策.

科学领域:

血管外科血管外科
外科手术的结果
预测分析是一种预测分析.

背景情况:

在破裂腹腔大动脉动脉瘤 (rAAA) 干预后预测30天死亡率的现有得分在性能上有所不同.
这项研究是第一个比较澳大利亚队列中的三个关键风险得分的研究,包括多样化的患者群体.

研究的目的:

为了比较三种风险预测得分 (Harborview风险得分,爱丁堡破裂动脉瘤得分,格拉斯哥动脉瘤得分) 对rAAA患者30天死亡率的区分能力.
评估这些分数在操作和非操作管理策略中的表现.

主要方法:

一项多中心的回顾性研究包括在2010年至2024年期间在新西兰进行的手术或非手术治疗的256名rAAA患者.
对每个患者计算出了三个风险分数 (HRS,ERAS,GAS).
使用接收器操作特征 (ROC) 曲线来评估每个分数的区分能力.

主要成果:

港湾风险评分 (HRS) 显示出优异的预测性能,内血管组的曲线下面面积 (AUC) 为0.83,开放修复组为0.69.
爱丁堡破裂动脉瘤评分 (ERAS) 和格拉斯哥动脉瘤评分 (GAS) 的AUC值较低 (分别为0.664和0.612).
每一次HRS增加1点都与30天死亡率增加2.4倍有关 (OR2.4,P<0.001).

结论:

在接受rAAA开放和内血管修复的患者中,HRS是预测30天死亡率的最有效得分.
将风险预测得分与临床判断相结合,可以提高rAAA患者的决策能力.

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