摘要
目的 检验分析中国冠状动脉旁路移植手术评分系统(SinoSCORE)对非体外循环冠状动脉旁路移植术(OPCABG)术后机械通气时间延长(PMV)的预测效能。方法 回顾性分析2015年2月至2020年6月期间在宁波市第一医院行OPCABG的患者96例。统计术后PMV发生情况,采用多因素Logistic回归模型分析影响因素,采用ROC评估SinoSCORE评分系统PMV的预测效能。结果 OPCABG术后PMV发生率为27.08%(26/96)。将患者分为PMV组(26例)与非PMV组(70例),PMV组的SinoSCORE评分高于PMV组,差异有统计学意义(t=12.421,P <0.05)。Logistic回归分析显示,年龄、COPD、术前NYHA分级、LVEF<50%、手术时间、SinoSCORE评分是术后发生PMV的独立危险因素[OR(95%CI)=1.472(1.083~2.136)、16.314(3.619~26.332)、1.281(1.169~9.785)、4.721(1.419~12.215)、1.434(1.079~1.789)、6.792(3.156~16.783),(P <0.05)]。SinoSCORE评分预测术后PMV的AUC为0.875,敏感度为76.92%,特异度为80.00%。结论 SinoSCORE对OPCABG术后PMV具有一定的预测效能,能够为术前准备、手术决策及术后干预提供参考依据。
Objective To investigate the predictive efficiency of Sino system for coronary operative risk evaluation(SinoSCORE) on prolonged mechanical ventilation(PMV) after off-pump coronary artery bypass grafting(OPCABG). Methods A retrospective study was performed on 96 cases of patients who were admitted to Ningbo First Hospital and underwent OPCABG from February 2015 to June 2020, the clinical data of patients was collected and analyzed. The occurrence of postoperative PMV in patients was observed, multivariate logistic regression model was used to analyze the influencing factors, the predictive performance of SinoSCORE on postoperative PMV was evaluated by receiver-operating characteristic(ROC) curve. Results The incidence of PMV after OPCABG was 27.08%(26/96). Patients were divided into the PMV group(26 cases) and non-PMV group(70 cases), the SinoSCORE score of the PMV group was higher than that in the non-PMV group, and the difference was statistically significant(t=12.421, P < 0.05). Logistic regression analysis showed that age, COPD, preoperative NYHA classification, LVEF<50%, operation time, SinoSCORE score were independent risk factors for PMV after surgery [OR(95%CI)=1.472(1.083-2.136), 16.314(3.619-26.332), 1.281(1.169-9.785), 4.721(1.419-12.215), 1.434(1.079-1.789), 6.792(3.156-16.783);P < 0.05]. The area under the ROC(AUC) of SinoSCORE score predicting postoperative PMV was 0.875, the sensitivity was 76.92%, the specificity was 80.00%. Conclusion SinoSCORE assessment system has certain prediction value for PMV after OPCABG, which can provide reference for preoperative preparation, surgical decisionmaking and postoperative intervention.
作者
齐砚庆
高亚坤
沈晓炜
邬弘宇
Qi Yanqing;Gao Yakun;Shen Xiaowei;Wu Hongyu(Department of Cardiovascular Surgery,Ningbo First Hospital,Ningbo 315010,China)
出处
《心脑血管病防治》
2022年第3期41-44,48,共5页
CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT
