CAJ | 학술논문

目的评估EuroSCORE对冠状动脉旁路移植术(CABG)患者术后早期死亡的预测价值.方法 2005年1月至2007年12月,共有310例患者接受CABG,收集患者的临床资料,包括EuroSCORE全部17项危险因子的详细数据,并进行评分.按预测病死率值的范围将所有患者分为低危组(0～2分)、中危组(3～5分)、高危组(6～13分),对每组的预测病死率和实际病死率进行对比研究.利用接受者工作特征(ROC)曲线评价EumSCORE的预测价值及准确性.结果术前危险评分,低危组患者占25.2%(78/310),中危组患者占48.4%(150/310),高危组患者占26.4%(82/310).预测病死率低危组1.4%,中危组2.7%,高危组7.4%;实际病死率三组分别为0、1.3%和3.7%.预测总病死率为3.6%,实际总病死率为1.6%.预测病死率和实际病死率之间有较好的一致性.ROC曲线下面积计算结果,整组患者为0.78,预测价值为中等.分组计算,非体外循环组为0.82,心肺转流组和合并瓣膜手术组为0.66,显示对其预测价值较低.结论 EuroSCORE对CABG患者预后有较好的预测价值,尤其是非体外循环手术患者.
목적 평고EuroSCORE대관상동맥방로이식술(CABG)환자술후조기사망적예측개치.방법 2005년1월지2007년12월,공유310례환자접수CABG,수집환자적림상자료,포괄EuroSCORE전부17항위험인자적상세수거,병진행평분.안예측병사솔치적범위장소유환자분위저위조(0～2분)、중위조(3～5분)、고위조(6～13분),대매조적예측병사솔화실제병사솔진행대비연구.이용접수자공작특정(ROC)곡선평개EumSCORE적예측개치급준학성.결과 술전위험평분,저위조환자점25.2%(78/310),중위조환자점48.4%(150/310),고위조환자점26.4%(82/310).예측병사솔저위조1.4%,중위조2.7%,고위조7.4%;실제병사솔삼조분별위0、1.3%화3.7%.예측총병사솔위3.6%,실제총병사솔위1.6%.예측병사솔화실제병사솔지간유교호적일치성.ROC곡선하면적계산결과,정조환자위0.78,예측개치위중등.분조계산,비체외순배조위0.82,심폐전류조화합병판막수술조위0.66,현시대기예측개치교저.결론 EuroSCORE대CABG환자예후유교호적예측개치,우기시비체외순배수술환자.
Objective To verify the predictive value of EuroSCORE of early mortality in coronary artery bypass grafting (CABG) patients. Method From January 2005 to March 2007, 310 consecutive patients were operated with CABG. Detailed data for the EuroSCORE risk factor were collected and all patients were scored according to the EuroSCORE additive model, retrospectively or prospectively. Expected or predicted mortality was calculated for individual patients using the EuroSCORE algorithms, arranged sequentially in order of predicted score. The population was divided into three clinically relevant risk categories according to the range of predicted mortality rate. Expected mortality was compared to observed or actual mortality for each risk category. Mortality was defined as death from any cause within 30 days of operation or within the same hospital admission. Results Preoperative overall patients: low-risk group was 25. 2% (78/310), middle-risk group was 48.4% (150/310), high-risk group was 26. 4% (82/310). In the EuroSCORE model, predicted mortality was 1.4% for low-risk group, 2.7% for middle-risk group, 7.4% for high-risk group, and 3.6% for overall patients. Actual mortality was 0, 1.3% and 3.7% respectively, overall early mortality was 1.6%. Area under the ROC curve was 0. 78. Conclusion The EuroSCORE yield good predictive value for hospital mortality of patients undergoing CABG, especially in off-pump CABG.