Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Arq Bras Cardiol. 2009 Apr;92(4):320-5. doi: 10.1590/s0066-782x2009000400012.
Some studies have developed scores for the assessment of surgical risk, particularly the EuroSCORE, which, however, is complex and difficult to apply. We suggest a new and simpler score, which is more appropriate for the clinical practice and for the assessment of surgical risk in patients with heart valve diseases.
This study was conducted to create and validate a simple and practical score to predict mortality and morbidity related to heart valve surgery.
Hospital data from 764 patients were collected, and the score was validated using two statistical models: death (= mortality) and length of hospital stay (LHS) > 10 days (= morbidity). The score was composed by four indexes (V [heart valve lesion], M [myocardial function], C [coronary artery disease], and P [pulmonary artery pressure]). A cut-off point was set for the score, and uni and multivariate analyses were performed to confirm whether the score would be able to predict mortality and morbidity. The existence of association with other risk factors was also studied.
The score was validated with good internal consistency (0.65), and the best cut-off point for mortality and morbidity was 8. Scores > 8 can predict LHS > 10 days (odds ratio [OR] = 1.7; p = 0.006) and a higher death risk, at least in the univariate analysis (p = 0.049). However, the death risk could not be predicted in the multivariate analysis (p=0.258).
VMCP scores > 8 can predict LHS > 10 days and may be used as a new tool for the follow-up of patients with heart valve disease undergoing surgery.
一些研究已经开发出了用于评估手术风险的评分系统，特别是 EuroSCORE，但它比较复杂，应用起来也有难度。我们提出了一种新的、更简单的评分系统，它更适合临床实践，也更适合评估心脏瓣膜疾病患者的手术风险。
本研究旨在创建并验证一种简单实用的评分系统，以预测与心脏瓣膜手术相关的死亡率和发病率。
收集了 764 例患者的医院数据，并使用两种统计模型对评分进行验证：死亡（=死亡率）和住院时间（LHS）>10 天（=发病率）。评分由四个指标（V [心脏瓣膜病变]、M [心肌功能]、C [冠状动脉疾病]和 P [肺动脉压]）组成。设定一个评分的临界点，进行单变量和多变量分析，以确认评分是否能够预测死亡率和发病率。还研究了与其他风险因素的关联。
评分具有良好的内部一致性（0.65），死亡率和发病率的最佳临界点为 8。得分>8 可以预测 LHS>10 天（优势比[OR] = 1.7；p = 0.006）和更高的死亡风险，至少在单变量分析中（p = 0.049）。然而，在多变量分析中无法预测死亡风险（p=0.258）。
VMCP 评分>8 可以预测 LHS>10 天，可以作为心脏瓣膜疾病手术患者随访的新工具。
