Validation of European System for Cardiac Operative Risk Evaluation (EuroSCORE) in North American cardiac surgery
Validation of European System for Cardiac Operative Risk Evaluation (EuroSCORE) in North American cardiac surgery
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DOI：
10.1016/s1010-7940(02)00208-7
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发表时间：
2002-07-01
影响因子：
3.4
通讯作者：
Ferguson, TB
中科院分区：
文献类型：
--
作者：
Nashef, SAM;Roques, F;Ferguson, TB
目的：旨在评估欧洲心脏手术风险评价系统（EuroSCORE）在北美心脏手术人群中应用时的性能。研究方法：应用简单相加EuroSCORE模型预测1998年和1999年接受冠状动脉或瓣膜手术的401 684例患者以及1995年接受胸外科医师协会（STS）数据库中的188 913例患者的手术死亡率（住院或30天）。结果：STS患者的孤立性冠状动脉旁路移植术（CABG）比例（84%）高于欧洲（65%）。STS患者年龄也较大（平均年龄65.3与62.5），糖尿病（30与17%）和既往心脏手术（11与7%）较多。其他合并症在STS患者中也明显更普遍。EuroSCORE预测的总死亡率与观察到的死亡率几乎相同（1998/1999：预测3.994%，观察3.992%; 1995：观察和预测4.156%）。预测的死亡率也与各风险组观察到的死亡率密切匹配。在两个时间段内，总体人群和单独CABG人群的区分度从良好到非常好，受试者工作特征曲线下面积在0.75和0.78之间。结论：尽管欧洲和北美之间存在很大的人口统计学差异，但EuroSCORE在STS数据库中的表现非常好，可以推荐作为大西洋两岸的一个简单的附加风险分层系统。(C)2002 Elsevier Science B. V.保留所有权利。
Objective: To assess the performance of the European System for Cardiac Operative Risk Evaluation (EuroSCORE) when applied in a North American cardiac surgical population. Methods: The simple additive EuroSCORE model was applied to predict operative mortality (in-hospital or 30-day) in 401 684 patients undergoing coronary or valve surgery in 1998 and 1999 as well as in 188 913 patients undergoing surgery in 1995 in the Society of Thoracic Surgeons (STS) database. Results: The proportion of isolated coronary artery bypass grafting (CABG) was greater in STS patients (84%) than in Europe (65%). STS patients were also older (mean age 65.3 versus 62.5), and had more diabetes (30 versus 17%) and prior cardiac surgery (11 versus 7%). Other comorbidity was also significantly more prevalent in STS patients. EuroSCORE predicted overall mortality was virtually identical to the observed mortality (1998/1999: predicted 3.994%, observed 3.992%; 1995: observed and predicted 4.156%). Predicted mortality also closely matched observed mortality across the risk groups. Discrimination was good to very good for the population overall and for isolated CABG in both time periods, with the area under the receiver operating characteristic curve between 0.75 and 0.78. Conclusion: Despite substantial demographic differences between Europe and North America, EuroSCORE performs very well in the STS database, and can be recommended as a simple, additive risk stratification system on both sides of the Atlantic. (C) 2002 Elsevier Science B.V. All rights reserved.