Division of Cardiology, Cardiac Catheterization Laboratory, NY Methodist Hospital, Brooklyn, New York 11215, USA.
Catheter Cardiovasc Interv. 2010 Feb 1;75(2):153-7. doi: 10.1002/ccd.22352.
Various risk assessment scores were proposed in the last decade for prediction of in-hospital mortality in patients undergoing percutaneous coronary intervention (PCI). We sought to apply two validated scores, the Mayo Clinic Risk Score (MCRS) and the New York Risk Score (NYRS) to a contemporary cohort treated at a single institution and to simplify the NYRS, such that the parameters used in both scores are similar.
Patients undergoing PCI in 2005-2007 were included. MCRS and NYRS were calculated for each patient. A simplified NYRS, similar to MCRS, was constructed by deleting two variables (gender and left main coronary stenosis). Model discrimination was assessed by the C statistic and goodness-of-fit (calibration) was measured with the Hosmer-Lemeshow test. There were 3,165 procedures. The in-hospital mortality was 0.56% (95% CI 0.31-0.83%). Mean MCRS was 2.7 +/- 2.4 (predicted mortality 0.3%). The C-statistic for MCRS was 0.82 (0.71-0.94) and the model was well calibrated (P = 0.79). Mean NYRS was 5.1 +/- 3.3, (predicted mortality 0.23%). The C-statistic for NYRS was 0.83 (0.74-0.95), not different from MCRS (P = 0.62) and the model was well calibrated (P = 0.29). The mean simplified NYRS was 4.6 +/- 3.1 among survivors and 10.9 +/- 5.8 among those who died, P < 0.001. The score had a C-statistic of 0.83 (0.71-0.95), not different from MCRS (P = 0.84) or NYRS (P = 0.27) and was well calibrated (P = 0.71).
PCI risk scores utilizing easily collected variables are useful in discriminating risk and predicting death. NYRS might be simplified by removing the gender and left main coronary stenosis variables from its algorithm.
在过去的十年中，提出了各种风险评估评分来预测接受经皮冠状动脉介入治疗（PCI）的患者的住院死亡率。我们试图将两个经过验证的评分，即梅奥诊所风险评分（MCRS）和纽约风险评分（NYRS）应用于单一机构治疗的当代队列，并简化 NYRS，使得两个评分中使用的参数相似。
纳入了 2005-2007 年接受 PCI 的患者。为每位患者计算了 MCRS 和 NYRS。通过删除两个变量（性别和左主干冠状动脉狭窄），构建了与 MCRS 相似的简化 NYRS。通过 C 统计量评估模型区分度，通过 Hosmer-Lemeshow 检验评估拟合优度（校准）。共有 3165 例手术。住院死亡率为 0.56%（95%CI 0.31-0.83%）。平均 MCRS 为 2.7+/-2.4（预测死亡率 0.3%）。MCRS 的 C 统计量为 0.82（0.71-0.94），模型校准良好（P=0.79）。NYRS 的平均值为 5.1+/-3.3，预测死亡率为 0.23%。NYRS 的 C 统计量为 0.83（0.74-0.95），与 MCRS 无差异（P=0.62），模型校准良好（P=0.29）。幸存者的简化 NYRS 平均为 4.6+/-3.1，死亡者为 10.9+/-5.8，P<0.001。该评分的 C 统计量为 0.83（0.71-0.95），与 MCRS（P=0.84）或 NYRS（P=0.27）无差异，且校准良好（P=0.71）。
利用易于收集的变量的 PCI 风险评分有助于区分风险和预测死亡。可以通过从其算法中删除性别和左主干冠状动脉狭窄变量来简化 NYRS。
