EuroHeart score for the evaluation of in-hospital mortality in patients undergoing percutaneous coronary intervention
EuroHeart score for the evaluation of in-hospital mortality in patients undergoing percutaneous coronary intervention
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DOI：
10.1093/eurheartj/ehr034
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发表时间：
2011-06-01
影响因子：
39.3
通讯作者：
Boersma, Eric
中科院分区：
文献类型：
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作者：
de Mulder, Maarten;Gitt, Anselm;Boersma, Eric
目的目前可用的风险预测模型对接受经皮冠状动脉介入治疗(PCIs)的患者的适用性有限。方法和结果我们的分析基于欧洲心绞痛患者的欧洲心脏调查，其中包含了在2005年至2008年期间176个欧洲参与中心的46064例不同适应症的连续接受冠状动脉介入治疗患者的信息。患者被随机分为训练组(n=23032)和验证组(n=23032)，两组特征相似。在这些组中，分别有339名(1.5%)和305名(1.3%)患者在住院期间死亡。在训练集的基础上，构建了16个独立的患者或病变特征与死亡率的Logistic模型，包括PCI指征、高龄、血流动力学不稳定、多支血管疾病和近端LAD疾病。在训练和验证数据集上，该模型在判别能力(C指数分别为0.91和0.90)和校正能力(Hosmer-LemeshowP值分别为0.39和0.18)方面都有较好的表现。结论包含16个因素的风险评分可以很好地预测冠状动脉介入治疗患者的住院死亡率。该分数对欧洲的做法具有很强的适用性。
Aims The applicability of currently available risk prediction models for patients undergoing percutaneous coronary interventions (PCIs) is limited. We aimed to develop a model for the prediction of in-hospital mortality after PCI that is based on contemporary and representative data from a European perspective.Methods and results Our analyses are based on the Euro Heart Survey of PCIs, which contains information on 46 064 consecutive patients who underwent PCI for different indications in 176 participating European centres during 2005-08. Patients were randomly divided into a training (n = 23 032) and a validation (n = 23 032) set with similar characteristics. In these sets, 339 (1.5%) and 305 (1.3%) patients died during hospitalization, respectively. On the basis of the training set, a logistic model was constructed that related 16 independent patient or lesion characteristics with mortality, including PCI indication, advanced age, haemodynamic instability, multivessel disease, and proximal LAD disease. In both the training and validation data sets, the model had a good performance in terms of discrimination (C-index 0.91 and 0.90, respectively) and calibration (Hosmer-Lemeshow P-value 0.39 and 0.18, respectively).Conclusion In-hospital mortality in PCI patients was well predicted by a risk score that contains 16 factors. The score has strong applicability for European practices.