Meta-Analysis Comparing Established Risk Prediction Models (EuroSCORE II, STS Score, and ACEF Score) for Perioperative Mortality During Cardiac Surgery
Meta-Analysis Comparing Established Risk Prediction Models (EuroSCORE II, STS Score, and ACEF Score) for Perioperative Mortality During Cardiac Surgery
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DOI：
10.1016/j.amjcard.2016.08.024
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发表时间：
2016-11-15
影响因子：
2.8
通讯作者：
Ioannidis, John P. A.
中科院分区：
文献类型：
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作者：
Sullivan, Patrick G.;Wallach, Joshua D.;Ioannidis, John P. A.
已经开发了各种各样的多变量风险模型来预测心脏手术中的死亡率;然而，这些模型的相对效用尚不清楚。本研究调查了与心脏手术围手术期死亡率的已建立风险预测模型之间的比较相关的文献。进行了一项系统性综述，以收集心脏手术中的研究，比较近期指南中引用的至少2种预测模型（欧洲心脏手术风险评价系统[EuroSCORE II]、胸外科医师协会2008年心脏手术风险模型[STS]评分和年龄、肌酐、射血分数[ACEF]评分）在1个月或住院死亡率结局方面的相对性能。对于符合纳入标准的文章，我们提取了有关研究设计、风险模型的预测性能和偏倚可能性的信息。进行荟萃分析以计算模型之间AUC差异的汇总估计值。我们确定了22项符合条件的研究，其中包含上述模型之间的33项比较。AUC差异的荟萃分析显示，EuroSCORE II和STS评分表现相似（具有汇总差异。AUC = 0.00），同时优于ACEF评分（AUC的汇总差异分别为0.10和0.08，p
A wide variety of multivariable risk models have been developed to predict mortality in the setting of cardiac surgery; however, the relative utility of these models is unknown. This study investigated the literature related to comparisons made between established risk prediction models for perioperative mortality used in the setting of cardiac surgery. A systematic review was conducted to capture studies in cardiac surgery comparing the relative performance of at least 2 prediction models cited in recent guidelines (European System for Cardiac Operative Risk Evaluation [EuroSCORE II], Society for Thoracic Surgeons 2008 Cardiac Surgery Risk Models [STS] score, and Age, Creatinine, Ejection Fraction [ACEF] score) for the outcomes of 1-month or inhospital mortality. For articles that met inclusion criteria, we extracted information on study design, predictive performance of risk models, and potential for bias. Meta-analyses were conducted to calculate a summary estimate of the difference in AUCs between models. We identified 22 eligible studies that contained 33 comparisons among the above models. Meta-analysis of differences in AUCs revealed that the EuroSCORE II and STS score performed similarly (with a summary difference. in AUC = 0.00), while outperforming the ACEF score (with summary differences in AUC of 0.10 and 0.08, respectively, p