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在预测患有心房的乳腺癌患者中风风险方面,B-S2CALED评分的实用性.

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概括

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节律失常 (arrhythmia) 是一种心律失常.乳腺癌 乳腺癌 乳腺癌这些指导方针是指导方针.风险预测风险预测查检查 查检查 查检查 查检查血栓形成的原因是血栓形成.

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科学领域:

  • 在瘤学瘤学.
  • 心脏病学 心脏病学
  • 医疗信息学 医疗信息学

背景情况:

  • 乳腺癌 (BC) 患者面临着心房动 (AF) 和缺血性中风 (IS) 的风险增加.
  • 现有的IS风险评分在癌症群体中缺乏验证,并且不包括癌症特异性因素.
  • 目前的临床指南缺乏针对AF的BC患者IS风险的量身定制的管理策略.

研究的目的:

  • 开发和验证一种新的IS风险预测评分,用于诊断为AF的BC患者.
  • 创建一个工具,解决癌症患者当前得分的局限性.

主要方法:

  • 利用了来自UH赛德曼癌症中心 (衍生/内部验证) 和MCG癌症中心 (外部验证) 的数据.
  • 包括DCIS或I-IVBC阶段的成年患者 (≥18岁),这些患者在诊断后发展出AF.
  • 采用LASSO考克斯回归用于变量选择,立方线用于连续预测器,以及多变量危险来制定B-S2CALED评分.
  • 使用对应性指数 (C指数) 和净重新分类改进 (NRI) 对CHA2DS2-VASc.使用评估歧视.

主要成果:

  • 在内部验证中 (n=935),B-S2CALED的C指数为0.64 (相对于CHA2DS2-VASc的0.54),NRI为0.188.
  • 在外部验证中 (n=95),B-S2CALED的C指数为0.77 (相对于CHA2DS2-VASc的0.53),NRI为0.563.
  • B-S2CALED评分在两个队列中都显示出对血栓栓塞事件的优异预测性能.

结论:

  • 开发的BC特定的B-S2CALED得分在预测AF的BC患者中IS风险方面明显优于CHA2DS2-VASc得分.
  • 在广泛临床实施之前,建议在更大的患者队伍中进一步验证.