European system for cardiac operative risk evaluation (EuroSCORE)
European system for cardiac operative risk evaluation (EuroSCORE)
复制标题
DOI：
10.1016/s1010-7940(99)00134-7
复制
发表时间：
1999-07-01
影响因子：
3.4
通讯作者：
Salamon, R
中科院分区：
文献类型：
--
作者：
Nashef, SAM;Rogues, F;Salamon, R
目的：在客观危险因素的基础上，建立一个预测欧洲心脏手术患者早期死亡率的scaring系统。方法：EuroSCORE数据库分为开发和验证子集。在前者中，根据回归分析对被认为客观、可信、可获得和难以伪造的风险因素进行加权。构建了预测死亡率的加性评分。在验证数据集中评估其校准和鉴别特征。定义了低、中、高风险群体的风险。结果如下：发育数据集有13302名患者，Hosmer Lemeshow卡方校准为（8）= 8.26（P < 0.40），ROC曲线下面积区分度为0.79。验证数据集有1479名患者，校准卡方（10）= 7.5，P < 0.68，ROC曲线下面积为0.76。评分系统确定了三组风险因素，括号中为权重（预测死亡率的加性%）。患者相关因素为年龄超过60岁（每5岁或不足5岁1例）、女性（1例）、慢性肺病（1例）、心外动脉病变（2例）、神经功能障碍（2例）、既往心脏手术史（3例）、血清肌酐>200 μ mol/l（2例）、活动性心内膜炎（3例）和术前危重状态（3例）。心脏因素包括静脉注射硝酸盐类药物引起的不稳定型心绞痛（2），左心室射血分数降低（30-50%：1，
Objective: To construct a scaring system for the prediction of early mortality in cardiac surgical patients in Europe on the basis of objective risk factors. Methods: The EuroSCORE database was divided into developmental and validation subsets. In the former, risk factors deemed to be objective, credible, obtainable and difficult to falsify were weighted on the basis of regression analysis. An additive score of predicted mortality was constructed. Its calibration and discrimination characteristics were assessed in the Validation dataset. Thresholds were defined to distinguish low, moderate and high risk groups. Results: The developmental dataset had 13 302 patients, calibration by Hosmer Lemeshow Chi square was (8) = 8.26 (P < 0.40) and discrimination by area under ROC curve was 0.79. The validation dataset had 1479 patients, calibration Chi square (10) = 7.5, P < 0.68 and the area under the ROC curve was 0.76. The scoring system identified three groups of risk factors with their weights (additive % predicted mortality) in brackets. Patient-related factors were age over 60 (one per 5 years or part thereof), female (1), chronic pulmonary disease (1), extracardiac arteriopathy (2), neurological dysfunction (2), previous cardiac surgery (3), Serum creatinine >200 mu mol/l (2), active endocarditis (3) and critical preoperative state (3). Cardiac factors were unstable angina on intravenous nitrates (2), reduced left ventricular ejection fraction (30-50%: 1,