3种心脏手术风险评估系统的应用研究

Applied Study on Three Assessment Systems for Cardiac Operative Risk

目的应用3种心脏手术风险评估系统对冠状动脉旁路移植术(CABG)进行预后指导,建立适合冠状动脉旁路移植术的风险评估系统.方法采用MODS,SOFA及COAS评分系统进行评分,比较3个系统对心脏术后风险评估的敏感性和特异性.结果分析比较3个系统的当日分值、Max分值、Max3d分值、Δ分值的ROC曲线下面积,MODS系统为0.602,0.847,0.838,0.767;SOFA系统为0.571,0.830,0.814,0.779;COAS系统为0.821,0.929,0.919,0.780;COAS系统各时段ROC曲线下面积均大于MODS和SOFA系统.结论 COAS系统在CABG术后风险评估的敏感性和特异性优于MODS和SOFA系统.

Objective To evaluate three assessment systems for cardiac operative risk in the instructive significance to coronary artery bypass graft（CABG） and establish a suitable risk assessment system for CABG.Method MODS,SOFA and COAS scores were calculated and the calibration and the discrimination of the three different systems were compared by using Hosmer-Lemeshow.Results The analysis and comparison on the three systems were performed,including the first day score,the maximum score,the three-day score,and the area under the ROC curve of Δ score.MODS values were 0.602,0.847,0.838,0.767;SOFA were 0.571,0.830,0.814,0.779,and COAS were 0.821,0.929,0.919,0.780;areas under the curve of COAS at the various times intervals were greater than those of MODS and SOFA.Conclusion The sensitivity and the speciality of COAS were better than those of MODS and SOFA in the prediction of mortality after CABG.