Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, Leiden 2333 ZA, The Netherlands.
Eur Heart J. 2010 Mar;31(6):712-8. doi: 10.1093/eurheartj/ehp497. Epub 2009 Nov 23.
To assess survival and to construct a baseline mortality risk score in primary prevention implantable cardioverter defibrillator (ICD) patients with non-ischaemic or ischaemic heart disease.
Since 1996, data of all consecutive patients who received an ICD system in the Leiden University Medical Center were collected and assessed at implantation. For the current study, all 1036 patients [age 63 (SD 11) years, 81% male] with a primary indication for defibrillator implantation were evaluated and followed for 873 (SD 677) days. During follow-up, 138 patients (13%) died. Non-ischaemic and ischaemic patients demonstrated similar survival but exhibited different factors that influence risk for mortality. A risk score, consisting of simple baseline variables could stratify patients in low, intermediate, and high risk for mortality. In non-ischaemic patients, annual mortality was 0.4% (95% CI 0.0-2.2%) in low risk and 9.4% (95% CI 6.6-13.1%) in high risk patients. In ischaemic patients, mortality was 1.0% (95% CI 0.2-3.0%) in low risk and 17.8% (95% CI 13.6-22.9%) in high risk patients.
Utilization of an easily applicable baseline risk score can create an individual patient-tailored estimation on mortality risk to aid clinicians in daily practice.
评估非缺血性或缺血性心脏病患者行植入式心脏复律除颤器（ICD）一级预防的生存率，并构建基线死亡率风险评分。
自 1996 年以来，莱顿大学医学中心连续植入 ICD 系统的所有患者的数据都被收集并在植入时进行评估。在当前的研究中，评估了所有 1036 名（年龄 63 岁±11 岁，81%为男性）具有一级除颤器植入指征的患者，并随访 873 天±677 天。随访期间，有 138 名患者（13%）死亡。非缺血性和缺血性患者的生存率相似，但影响死亡率的风险因素不同。一个由简单基线变量组成的风险评分，可以将患者分为低危、中危和高危死亡率分层。在非缺血性患者中，低危患者的年死亡率为 0.4%（95%CI 0.0-2.2%），高危患者的年死亡率为 9.4%（95%CI 6.6-13.1%）。在缺血性患者中，低危患者的死亡率为 1.0%（95%CI 0.2-3.0%），高危患者的死亡率为 17.8%（95%CI 13.6-22.9%）。
使用易于应用的基线风险评分可以对患者的死亡率风险进行个体化评估，有助于临床医生在日常实践中进行决策。
