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术前心脏风险计算器在尿道外前列腺手术中的准确性

Mohammadali Saffarzadeh¹, Ghizlane Moussaoui¹, Adam Dorner²

¹Department of Urologic Sciences, University of British Columbia, Vancouver, Canada.

Journal of endourology

|March 4, 2026

概括

修订后的心脏风险指数 (RCRI) 在前列腺手术患者中高估了心脏事件,而美国外科医生学院国家外科质量改善计划 (NSQIP) 准确地预测了结果. 这凸显了需要更好的风险评估工具在泌尿外科手术.

科学领域:

泌尿外科手术泌尿外科手术
心脏病学心脏病学
手术风险评估手术风险评估

背景情况:

经过修订的心脏风险指数 (RCRI) 和美国外科医生院国家外科质量改善计划 (NSQIP) 是预测非心脏手术中30天后心脏事件的确立工具.
他们的预测准确性在微创性穿尿道前列腺手术的背景下仍然没有评估.

研究的目的:

为了比较RCRI和NSQIP对术后心脏事件的预测准确度,与经过尿道前列腺手术的患者观察到的实际发病率进行比较.
评估现有的心脏风险指数在接受微创性泌尿外科手术的特定人群中的有用性.

主要方法:

在2022年7月至12月期间接受过尿道式前列腺手术的185名患者的回顾性评估.
基于心脏VISION研究标准的30天术后心脏事件的评估.
计算RCRI和NSQIP心脏事件预测,并使用费舍尔精确测试与观察到的事件进行比较.

主要成果:

该研究包括185名患者 (平均年龄为73±8.4岁),其中46%接受过尿道切除前列腺,54%接受过Holmium激光前列腺去核切除.
RCRI预测心脏事件发生率为4.8%,明显高于观察到的0.5%发病率 (p=0.0198).
NSQIP预测心脏事件发生率为0.54%,与观察到的发病率没有显著差异 (p=1).

结论:

在接受过尿道前列腺手术的患者中,RCRI显著高估了30天的心脏风险.
NSQIP的预测与该手术队列中观察到的心脏事件发生率非常一致.
采用更准确的预测工具对于改善风险分层和为患者和外科医生的决策提供信息至关重要.

关键词:

在 HoLEP 里面.在 MINS 找 MINS.这是NSQIP.这是一个RCRIRCRI.翻过身来翻过身去的情况.心脏事件发生的心脏事件.诺莫格拉姆 (Nomograms) 是一个名字.

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