摘要
目的:评估欧洲心血管手术危险因素评分(EuroSCORE)系统预测我国冠状动脉旁路移植术(CABG)后早期预后的预测能力。方法:回顾性分析2006-06-01至2007-12-31我院心脏外科行CABG手术或CABG合并手术的1623例患者资料,使用EuroSCORE的加法模型(additive)及对数回归模型(logistic)评估所有患者的死亡、重症监护病房(ICU)时间延长以及主要并发症的发生,并评价其效能,分辨能力评价采用受试者工作特征(ROC)曲线,校准度评价采用Hosmer-Lemeshowχ2检验。结果:EuroSCORE的additive模型及logistic模型预测术后死亡的ROC曲线下面积分别是0.787和0.801,ICU时间延长的ROC曲线下面积分别是0.725和0.741,术后呼吸功能衰竭的ROC曲线下面积分别是0.692和0.702,术后肾功能衰竭的ROC曲线下面积分别是0.788和0.796,二次开胸止血的ROC曲线下面积分别是0.711和0.723。Hosmer-Lemeshowχ2检验结果:additive模型拟合优度较好,P值均大于0.05,logistic模型拟合优度不佳,P值除预测ICU时间延长一项大于0.05,其余均小于0.05。结论:EuroSCORE对我国CABG患者手术死亡、ICU时间延长、术后呼吸功能衰竭、术后肾功能衰竭、二次开胸止血预测能力中等,且additive模型的预测精度优于logistic模型。
Objective： To assess the clinical value of EuroSCORE for predicting the early prognosis in patients with coronary artery bypass grafting （CABG） in China. Methods： We retrospectively summarized the data of 1623 patients who underwent CABG or combined with CABG surgery from June 2006 to December 2007 in our hospital. The EuroSCORE additive model and muhiple regression model were performed to assess the postoperative mortality, the extended ICU time and the major important complications. The resolution ability was evaluated by the receiver operating characteristic （ROC） curve and the calibration evaluation was conducted by Hosmer-Lemeshow X2 test. Results ： The additive model and the logistic model of EuroSCORE predicted that the postoperative mortality area under ROC curves were 0. 787 and 0. 801 respectively, the extended ICU time were 0. 725 and 0. 741 ,the postoperative respiratory failure were 0. 692 and 0. 702, the postoperative kidney failure were 0. 788 and 0. 796, the second open thoracic surgery for bleeding were 0. 711 and 0. 723 respectively. Hosmer-Lemeshow X2 test presented that the additive model had the better fit than the logistic model. Conclusion ： Our work indicated that the clinical value of EuroSCORE was at the middle level in Chinese patients for predicting the CABG mortality,the extended ICU time, the postoperative renal failure and the second open thoracic surgery for bleeding. The additive model had the better prediction accuracy than the logistic model.
出处
《中国循环杂志》
CSCD
北大核心
2010年第5期379-382,共4页
Chinese Circulation Journal
