摘要
目的验证心脏麻醉危险评估(CARE)评分是否适用于我国行冠状动脉旁路移植术(CABG)的患者,同时比较CARE评分与欧洲心脏手术危险因素评价系统(EuroSCORE)对CABG预后[术后病死率、术后并发症、住院天数、术后住院天数和住重症监护病房(ICU)天数]的预测能力。方法 收集上海交通大学医学院附属仁济医院麻醉科2007年6月—2008年12月行CABG的患者212例,对其进行CARE评分和EuroSCORE评分,比较住院天数、术后住院天数、住ICU天数与这两种风险评分的相关性及这两种风险评分对手术病死率和并发症发生率的校准度和分辨力,由此来衡量两者对国人行CABG患者预后的预测能力。结果 EuroSCORE与行心脏手术患者的住院天数、术后住院天数和住ICU天数呈正相关(r=0.108、0.141、0.181,P值均<0.05);CARE评分与患者住院天数不相关,但与术后住院天数和住ICU天数呈正相关(r=0.188、0.212,P值均<0.01)。CARE评分和EuroSCORE对术后病死率的校准度均较好(χ2=1.1172、1.3992,P=0.9526、0.4968),CARE评分对于术后并发症发生率的校准度可以接受(χ2=7.8023,P=0.1675),但对术后住院时间延长的校准度较差(χ2=21.2669,P=0.0126)。CARE评分对于术后病死率的分辨力较好但不如EuroSCORE,两者受试者工作特征曲线下面积(AUC)分别为0.723和0.907,两者术后并发症发生率的分辨力均为中等(AUC分别为0.648和0.684)。结论 CARE评分和EuroSCORE对国人CABG后病死率、术后并发症发生率及术后住院天数和住ICU天数均有良好的预测能力。
Objective To know whether the Cardiac Anesthesia Risk Evaluation（CARE）score is suitable for Chinese patients undergoing coronary artery bypass grafting（CABG）,and to compare the values of CARE and European System for Cardiac Operative Risk Evaluation（EuroSCORE）in predicting the outcomes of CABG patients（operative mortality,postoperative complications,hospital stay,postoperative hospital stay,and days in ICU）.Methods The clinical data of 212 patients who received CABG during Jun.2007 to Dec.2008 were retrospectively analyzed.They were all assessed by CARE system and EuroSCORE system by an anesthesiologist.The correlations of the two risk models with length of hospital stay,postoperative hospital stay and ICU stay were assessed by correlation analysis.Calibration and discrimination for predicting the outcomes were assessed by Pearson chi-square goodness-of-fit test and area under the receiver operating characteristic curve,respectively.Results The correlation between EuroSCORE and length of hospital stay,postoperative hospital stay and ICU stay was significant（all P0.05）.The correlation between the CARE score and length of hospital stay was not significant（P0.05）,and the correlation between the CARE score and postoperative hospital stay and ICU stay was significant（both P0.01）.The calibration analysis revealed no significant difference between the expected and the observed mortality for the two risk models（χ2=1.117 2,1.399 2;P=0.952 6,0.496 8）.The CARE score also had acceptable calibration in predicting morbidity（χ2=7.802 3,P=0.167 5）,but had an unacceptable one in predicting prolonged hospital stay（χ2=21.266 9,P=0.012 6）.The areas under the receiver operating characteristic curves for mortality were 0.723 with the CARE score and 0.907 with the EuroSCORE;and the areas under the receiver operating characteristic curves for morbidity were 0.648 with the CARE score and 0.684 with the EuroSCORE.Conclusions Both CARE score and EuroSCORE have a satisfactory capability for predicting the mortality,postoperative hospital stay and ICU stay in Chinese patients undergoing CABG.
出处
《上海医学》
CAS
CSCD
北大核心
2011年第2期102-106,共5页
Shanghai Medical Journal
关键词
心脏麻醉危险评估评分
欧洲心脏手术危险因素评价系统
冠状动脉旁路移植术
Cardiac Anesthesia Risk Evaluation score
European System for Cardiac Operative Risk Evaluation
Coronary artery bypass grafting
