Validation of long-term survival prediction for scheduled abdominal aortic aneurysm repair with an independent calculator using only pre-operative variables

Validation of long-term survival prediction for scheduled abdominal aortic aneurysm repair with an independent calculator using only pre-operative variables
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DOI:
10.1111/anae.13061
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发表时间:
2015-06-01
期刊:
影响因子:
10.7
通讯作者:
Swart, M.
Swart, M.
中科院分区:
医学1区
文献类型:
--
作者:
Carlisle, J. B.;Danjoux, G.;Swart, M.

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我们观察了1096例患者腹主动脉瘤计划修复后的中位生存期(IQR [范围])为3.0(1.5-5.8 [0-15])年:943例患者有完整数据,其中250例死亡。我们比较了从研究数据生成的Kaplan-Meier模型的外部模型的识别和校准。术后1-5年,两种模型的综合Brier错误分类评分分别为0.04、0.08、0.11、0.13和0.16。术后1-5年的Harrel一致性指数分别为0.73、0.71、0.68、0.67和0.66。中位5年预测死亡率为40%(n=251)、18%(n=414)和8%(n=164)的组的观察死亡率低于114例预测死亡率为70%的患者,风险比(95% CI):0.58(0.37-0.76),p=0.0031; 0.30(0.19-0.48),p=1.7x10(-12)和0.19(0.13-0.27),p=1.3x10(-10),趋势检验p=5.6x10(-15)。外部计算器预测的生存率与Kaplan-Meier估计值相似。
We observed survival after scheduled repair of abdominal aortic aneurysm in 1096 patients for a median (IQR [range]) of 3.0 (1.5-5.8 [0-15])years: 943 patients had complete data, 250 of whom died. We compared discrimination and calibration of an external model with the Kaplan-Meier model generated from the study data. Integrated Brier misclassification scores for both models at 1-5 postoperative years were 0.04, 0.08, 0.11, 0.13 and 0.16, respectively. Harrel's concordance index at 1-5 postoperative years was 0.73, 0.71, 0.68, 0.67 and 0.66, respectively. Groups with median 5-year predicted mortality of 40% (n=251), 18% (n=414) and 8% (n=164) had lower observed mortality than 114 patients with 70% predicted mortality, hazard ratio (95% CI): 0.58 (0.37-0.76), p=0.0031; 0.30 (0.19-0.48), p=1.7x10(-12) and 0.19 (0.13-0.27), p=1.3x10(-10), respectively, test for trend p=5.6x10(-15). Survival predicted by the external calculator was similar to the Kaplan-Meier estimate.