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新旧两版风险预测模型对单纯二尖瓣置换术后死亡风险预测的比较 被引量：4

Comparison of Logistic Euro SCORE and Euro SCORE Ⅱ in patients undergoing mitral valve replacement surgery
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摘要 目的评价Logistic Euro SCORE与Euro SCOREⅡ风险预测模型对本中心成人单纯二尖瓣置换术后在院死亡率预测的准确性。方法回顾性收集2009年1月至2013年12月497例患者在院接受单纯二尖瓣置换术的临床资料,包括同期行三尖瓣成形、左房减容、左心耳闭合术患者。其中男性186例,女性311例,平均(53.19±11.11)岁。按照第一版的Logistic Euro SCORE模型与新版的Euro SCOREⅡ模型给予评分获得患者的预测死亡率,与患者的实际在院死亡率比较。模型预测的符合程度应用Hosmer-Lemeshow拟和优度检验,而预测的鉴别效度则通过受试者工作特征曲线(ROC)下面积反映。结果497例患者在院死亡6例,全组实际在院死亡率为1.21%,logistic Euro SCORE及Euro SCOREⅡ预测的在院死亡率分别为2.99%和1.53%。其中Euro SCOREⅡ对全组患者在院死亡率预测符合程度较高,而logistic Euro SCORE明显高估了在院死亡率。logistic Euro SCORE的区分度及校准度差(P=0.673,AUC=0.621),Euro SCOREⅡ区分度及校准度均较好(P=0.894,AUC=0.793)。结论 Euro SCOREⅡ对本中心单纯二尖瓣置换手术患者在院死亡风险预测的准确性较高。 Objective To assess the value of Logistic Euro SCORE and Euro SCORE Ⅱ in predicating in-hospital mortality among Chinese patients undergoing mitral valve replacement surgery in our center. Methods 497 patients who underwent mitral valve replacement with or without concomitant tricuspid valvuloplasty,left atrium reduction and left auricle closure from January 2009 to December 2013 in our department were enrolled in our study. The mean age was 53. 19±11. 11 years at the time of surgery,and 62. 6%were female. They were scored by logistic Euro SCORE and Euro SCOREⅡ model,and compared with observed in-hospital mortality.Calibration was evaluated by Hosmer-Lemeshow（ H-L） test,and discrimination was evaluated by the area under the receiver operating characteristic（ ROC） curve. Results There were 6 in-hospital deaths among the 497 patients and the in-hospital mortality rate was1. 21%,compared with the predicted mortality rate of 2. 99% by Logistic Euro SCORE and 1. 53% by Euro SCOREⅡ. Logistic Euro SCORE suggested a high prediction,and Euro SCOREⅡ suggested a similar mortality. The discrimination of Logistic Euro SCORE was poor（ P = 0. 673,AUC = 0. 621）. Euro SCOREⅡ showed good calibration and discrimination（ P = 0. 894,AUC = 0. 793）. Conclusion The Euro SCOREⅡ was suitable in predicting the mortality of mitral valve replacement surgery patients in our department.
作者 陈磊 高长青 肖苍松 姜胜利
机构地区 解放军总医院心血管外科全军心脏外科研究所
出处 《中国体外循环杂志》 2015年第1期33-36,共4页 Chinese Journal of Extracorporeal Circulation
关键词 二尖瓣置换术 在院死亡率 LOGISTIC EUROSCORE EuroSCOREⅡ Mitral valve replacement surgery In-hospital mortality Logistic Euro SCORE Euro SCOREⅡ
分类号 R654.2 [医药卫生—外科学]
  • 相关文献

参考文献9

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二级参考文献16

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共引文献5

同被引文献49

  • 1崔虎军,肖峰,李岩,信维强,张明礼,王进,杨阳.心脏手术风险评估欧洲系统(EuroSCORE)的初步临床应用[J].中国心血管病研究,2006,4(1):24-27. 被引量：6
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中国体外循环杂志
2015年 第1期

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