TIMI评分对急诊急性心肌梗死患者30天预后的预测价值

The Value of TIMI Risk Score in Predicting 30-day outcome of STEMI Patients Presented to Emergency Department

目的:评价早期TIMI评分对急诊室ST段抬高型心肌梗死(STEMI)患者30 d预后的预测价值。方法:使用前瞻性观察研究的方法,收集2012年3月17日至2013年8月14日在我院急诊室首诊的年龄≥18岁确诊的STEMI患者。记录患者临床资料,完成TIMI评分的计算,并对纳入的病例进行30天的随访。随访的内容为30天心血管不良事件。结果:本研究共收集了119例STEMI患者,平均年龄为65.8±13.3岁,男性患者占82.4%。患者30天的心血管不良事件的发生率为14.3%。TIMI评分对30天全因死亡有良好的预测价值,AUC分别是0.785,统计学Cutoff为>5时的敏感性为82.3%,特异性为59.8%,TIMI评分≤2分者的患者30天内没有发生死亡,其敏感性达到100%,特异性为21.57%。结论:TIMI评分能有效地预测急诊室STEMI患者30天的预后,Cutoff值可根据受试人群的情况进行调整。

Objectives ： To explore the validation of TIMI risk score for the patients presenting to Emergency Department（ED） with ST-segment elevation myocardial infarction（STEMI）. Methods ： Patients presented in our ED with STEMI over 18 years old were enrolled from March 17, 2012 to August 14,2013. Clinical data and items of 4scores were remarked. All cause death of each patient were followed up at 30 days by Health insurance information management System and phone. Results ： Total 119 STEMI patients were enrolled（mean age 65.8±13.3years; 17.6%female）.The mortality within 30 days was14.3%.The respective areas under the curve（AUC） for 30-day death was0.785. When the cutoff value of TIMI was more than 5, the sensitivity was 82.3% and specificity was 59.8%. The sensitivity was increase to 100 % by cutoff less than 2 score when the specificity was21.57%. Conclusion ：TIMI risk score performed well for 30-day death of STEMI patients in Emergency Department. The cutoff value can be adjusted according to the characteristics of patient subjects.