Kunt Ayse Gul, Kurtcephe Murat, Hidiroglu Mete, Cetin Levent, Kucuker Aslihan, Bakuy Vedat, Akar Ahmet Ruchan, Sener Erol
Cardiovascular Clinics, Ataturk Education and Research Hospital, Ankara, Turkey.
Interact Cardiovasc Thorac Surg. 2013 May;16(5):625-9. doi: 10.1093/icvts/ivt022. Epub 2013 Feb 12.
The aim of this study was to compare additive and logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE), EuroSCORE II and the Society of Thoracic Surgeons (STS) models in calculating mortality risk in a Turkish cardiac surgical population.
The current patient population consisted of 428 patients who underwent isolated coronary artery bypass grafting (CABG) between 2004 and 2012, extracted from the TurkoSCORE database. Observed and predicted mortalities were compared for the additive/logistic EuroSCORE, EuroSCORE II and STS risk calculator. The area under the receiver operating characteristics curve (AUC) values were calculated for these models to compare predictive power.
The mean patient age was 74.5 ± 3.9 years at the time of surgery, and 35.0% were female. For the entire cohort, actual hospital mortality was 7.9% (n = 34; 95% confidence interval [CI] 5.4-10.5). However, the additive EuroSCORE-predicted mortality was 6.4% (P = 0.23 vs observed; 95% CI 6.2-6.6), logistic EuroSCORE-predicted mortality was 7.9% (P = 0.98 vs observed; 95% CI 7.3-8.6), EuroSCORE II- predicted mortality was 1.7% (P = 0.00 vs observed; 95% CI 1.6-1.8) and STS predicted mortality was 5.8% (P = 0.10 vs observed; 95% CI 5.4-6.2). The mean predictive performance of the analysed models for the entire cohort was fair, with 0.7 (95% CI 0.60-0.79). AUC values for additive EuroSCORE, logistic EuroSCORE, EuroSCORE II and STS risk calculator were 0.70 (95% CI 0.60-0.79), 0.70 (95% CI 0.59-0.80), 0.72 (95% CI 0.62-0.81) and 0.62 (95% CI 0.51-0.73), respectively.
EuroSCORE II significantly underestimated mortality risk for Turkish cardiac patients, whereas additive and logistic EuroSCORE and STS risk calculators were well calibrated.
本研究旨在比较欧洲心脏手术风险评估系统（EuroSCORE）的相加法和逻辑回归法、EuroSCORE II以及胸外科医师协会（STS）模型在计算土耳其心脏手术人群死亡风险方面的表现。
当前的患者群体包括2004年至2012年间接受单纯冠状动脉旁路移植术（CABG）的428例患者，数据来自TurkoSCORE数据库。对相加法/逻辑回归法EuroSCORE、EuroSCORE II和STS风险计算器的观察到的死亡率和预测的死亡率进行比较。计算这些模型的受试者工作特征曲线（AUC）下的面积值，以比较预测能力。
手术时患者的平均年龄为74.5±3.9岁，女性占35.0%。对于整个队列，实际医院死亡率为7.9%（n = 34；95%置信区间[CI] 5.4 - 10.5）。然而，相加法EuroSCORE预测的死亡率为6.4%（与观察值相比P = 0.23；95% CI 6.2 - 6.6），逻辑回归法EuroSCORE预测的死亡率为7.9%（与观察值相比P = 0.98；95% CI 7.3 - 8.6），EuroSCORE II预测的死亡率为1.7%（与观察值相比P = 0.00；95% CI 1.6 - 1.8），STS预测的死亡率为5.8%（与观察值相比P = 0.10；95% CI 5.4 - 6.2）。分析的模型对整个队列的平均预测性能为中等，AUC值为0.7（95% CI 0.60 - 0.79）。相加法EuroSCORE、逻辑回归法EuroSCORE、EuroSCORE II和STS风险计算器的AUC值分别为0.70（95% CI 0.60 - 0.79）、0.70（95% CI 0.59 - 0.80）、0.72（95% CI 0.62 - 0.81）和0.62（95% CI 0.51 - 0.73）。
EuroSCORE II显著低估了土耳其心脏患者的死亡风险，而相加法和逻辑回归法EuroSCORE以及STS风险计算器的校准效果良好。
