Bedside estimation of risk as an aid for decision-making in cardiac surgery
Bedside estimation of risk as an aid for decision-making in cardiac surgery
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DOI：
10.1016/s0003-4975(99)01424-1
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发表时间：
2000-03-01
影响因子：
4.6
通讯作者：
Parsonnet, V
中科院分区：
文献类型：
--
作者：
Bernstein, AD;Parsonnet, V
背景资料。只有在将观察死亡率与手术前风险因素考虑在内的预期死亡率进行比较时，医院和外科医生对心脏手术死亡率的评估才是公平和现实的。风险近似计算还可以帮助患者和医生讨论心脏手术的风险，特别是如果手术死亡率的估计考虑了所有重要的风险因素。建立了考虑47个潜在危险因素的Logistic回归模型，并设计了一种只需简单相加和图形解释的方法，仅用Raper和铅笔就能方便、快速地逼近估计的风险。简化模型提供的估计值与观察死亡率有很好的相关性。Logistic回归模型的一个简单近似已被发现有助于医生和考虑进行主-冠脉搭桥术或瓣膜相关手术的患者之间的讨论。(C)2000年，胸外科医生学会。
Background. Evaluations of the cardiac-surgery mortality rates of hospitals and surgeons can be fair and realistic only when the observed mortality rates are compared with expected rates with preoperative risk factors taken into account. Risk-approximation calculations also can assist patients and physicians in discussing the risk of cardiac surgery, especially if the estimation of surgical mortality takes all of the important risk factors into account.Methods. A logistic regression model was developed in which 47 potential risk factors were considered, and a method requiring only simple addition and graphic interpretation was designed for approximating the estimated risk easily and quickly, with Raper and pencil alone.Results. The estimates provided by the simplified model correlated well with the observed mortality rates.Conclusions. A simple approximation of a logistic regression model has been found to be helpful in discussions between physicians and patients contemplating aortocoronary bypass or valve-related surgery.(C) 2000 by The Society of Thoracic Surgeons.