增强感染性内心炎手术风险分层:对所有可用的死亡率预测得分进行全面的外部验证
Elisa Mikus1, Diego Sangiorgi1, Simone Calvi1
1Cardiovascular Department, Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy.
Clinical epidemiology
|December 26, 2025
概括
风险-E评分最好预测感染性内心炎 (IE) 手术患者的手术死亡率. 这项研究验证了IE特定的风险评分,发现RISK-E优于像EuroSCORE II这样的通用模型.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 传染性内心炎研究 传染性内心炎研究
背景情况:
- 感染性内心炎 (IE) 手术的预后模型具有不确定的外部有效性.
- 现有的模型可能无法准确预测不同患者队列的手术死亡率.
研究的目的:
- 为了外部验证和比较IE特异性和通用心脏手术风险得分.
- 评估一个大型单中心IE患者队列中的风险评分的表现.
主要方法:
- 追溯应用了18个IE特异性和EuroSCORE II风险评分给689名IE手术患者.
- 使用AUC和通过Hosmer-Lemeshow,Brier分数和校准斜率进行校准来评估歧视.
- 为了评分可靠性,包括评估的IE特定变量.
主要成果:
- 操作死亡率为10.6%. 风险-E评分显示了最高的歧视 (AUC:0.742),其次是APORTEI和修改后的MELD-XI.
- 所有分数都显示出良好的校准;IE特定的分数通常表现更好.
- 像EuroSCORE II这样的通用评分高估了风险;外部验证的AUC值低于原始报告.
结论:
- 风险-E评分显示出优异的区分能力和校准,用于预测IE手术中的手术死亡率.
- 外部验证,IE特定的预后工具对于临床评估和术后策略选择至关重要.
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