SinoSCORE预测心血管外科手术病死率——广东心血管病研究所经验
Validation of the Chinese system for cardiac operative risk evaluation (SinoSCORE): the experience from Guangdong Cardiovascular Institute
郭惠明 1吴若彬 1肖学钧 1郑少忆 1卢聪 1黄劲松 1麦明杰 1黄克力 1谢斌1
作者信息
- 1. 500100,广州,广东省心血管病研究所,广东省医学科学院,广东省人民医院心外科
- 折叠
摘要
目的 评价中国冠状动脉旁路移植手术风险评分系统(SinoSCORE)在预测广东病人心脏手术后院内死亡的临床应用价值.方法 2004年1月到2008年12月,广东心血管病研究所2462例成人心脏病病人接受冠状动脉旁路移植或者瓣膜手术进入注册登记数据库.比较该组病人与SinoSCORE的来源数据库的术前风险因子的区别.通过计算每例病人的SinoSCORE累计积分,分别评价SinoSCORE对该组的病人院内病死率的区分度和校准度.结果 广东病人的性别、吸烟、糖尿病、高脂血症、高血压、脑卒中、慢性肺病、心血管手术史、房颤/房扑、左主干、合并肺高压、合并冠脉手术及合并瓣膜手术较SinoSCORE来源数据库差异有统计学意义,但SinoSCORE仍可以很好地预测广东病人的院内病死率,模型表现出很好的校准度(Hosmer-Lemeshow拟合优度检验,P=0.34)和区分度(ROC曲线下面积,0.84,P<0.01).结论 SinoSCORE可以用来预测广东病人心脏外科手术后院内死亡.
Abstract
Objective To validate of the Chinese system for cardiac operative risk evaluation (SinoSCORE) in Cantonese surgery patients. Methods Data from Guangdong Cardiovascular Institute in the period January 2004 through December 2008 were analyzed on 2462 Cantonese heart surgery patients. First, compared risk factors of this series and database of SinoSCORE, and then calculated the additive score of each patients and evaluate the discrimination and calibration of sinoSCORE in Cantonese patients. Results There were some differences between the risk factors of patients from two groups. The gender,smoking, diabetes, hyperlipemia, hypertension, chronic pulmonary diseases, stroke, cardiovascular surgery history, left main disease, atrial fibrillation/atrial flutter, pulmonary arterial hypertension, concomitant coronary surgery and concomitant valve surgery in Cantonese patients were different between two groups. However, The SinoSCORE was able to predict the in-hospital mortality of senior patients with good discrimination ( Hosmer-Lemeshow test, P = 0. 34 ) and calibration ( the area under the receiver operating characteristic curve, 0.84, P < 0.01 ). Conclusion SinoSCORE was able to predict the in-hospital mortality of Cantonese heart surgery patients.
关键词
心脏外科手术/危险性评估/SinoSCORE/危险因素/广东病人Key words
Cardiac surgical procedures/Risk assessment/sinoSCORE/Risk factors/Cantonese patient引用本文复制引用
出版年
2011