How Accurate Is the Eyeball Test? A Comparison of Physician's Subjective Assessment Versus Statistical Methods in Estimating Mortality Risk After Cardiac Surgery
How Accurate Is the Eyeball Test? A Comparison of Physician's Subjective Assessment Versus Statistical Methods in Estimating Mortality Risk After Cardiac Surgery
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DOI：
10.1161/circoutcomes.113.000329
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发表时间：
2014-01-01
影响因子：
6.9
通讯作者：
Adabag, Selcuk
中科院分区：
文献类型：
--
作者：
Jain, Renuka;Duval, Sue;Adabag, Selcuk
背景在心脏病经皮治疗选择越来越多的时代，手术风险的估计已成为选择最佳治疗策略的关键因素。手术风险历来估计由医生的主观评估，最近的统计风险estimations.Methods和结果，我们研究了5099连续患者在明尼阿波利斯退伍军人事务部医疗中心1993年和2010年之间接受心脏手术。手术死亡风险由退伍军人事务部死亡风险估计进行统计学估计，并由心脏外科医生在手术前进行主观估计。术后1个月观察到的死亡率为3.3%（168例死亡），1年为7.1%（360例死亡），5年为18.5%（942例死亡）。医生的风险估计（平均值[SD]，5.6% [4.4]）和统计学风险估计（4.3% [5.1]）有适度的相关性（c指数，0.56; P
Background In the era of increasing percutaneous treatment options for heart disease, the estimation of surgical risk has become a key factor in selecting optimal treatment strategies. Surgical risk has historically been estimated by physician's subjective assessment and more recently by statistical risk estimates.Methods and Results We studied 5099 consecutive patients who underwent cardiac surgery at Minneapolis Veterans Affairs Medical Center between 1993 and 2010. Operative mortality risk was estimated statistically by the Veterans Affairs mortality risk estimate and subjectively by cardiac surgeons before surgery. Observed mortality rate was 3.3% (168 deaths) at 1 month, 7.1% (360 deaths) at 1 year, and 18.5% (942 deaths) at 5 years after surgery. Physician's risk estimate (mean [SD], 5.6% [4.4]) and statistical risk estimate (4.3% [5.1]) had modest correlation (c-index, 0.56; P