Cardiovascular Department, Ferrarotto Hospital, Catania, Italy.
Am J Cardiol. 2013 Aug 1;112(3):323-9. doi: 10.1016/j.amjcard.2013.03.032. Epub 2013 Apr 30.
The aim of the present study was to externally validate the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II (ESII) in patients undergoing percutaneous coronary intervention (PCI) and to compare its performance with that of its previously released versions, named additive (addES) and logistic EuroSCORE (logES). A total of 537 patients undergoing PCI were analyzed by different measurements of discrimination, calibration, and global accuracy. A significant gradient in all-cause mortality was seen with all the models at 30 days, 1 year, and 5 years, with the exception of the ESII at 30 days. The ESII had the lowest area under the receiver operating characteristic curve at all time points compared with its previous version, being 0.83 (vs 0.90 for both addES and logES) at 30 days, 0.75 (vs 0.82 for both addES and logES) at 1 year, and 0.69 (vs 0.77 for addES and 0.76 for logES) at 5 years. However, the ESII displayed a better calibration than the logES at 30 days, whereas both scores were miscalibrated at 1 and 5 years. The Brier score displayed similar global accuracy between the ESII and logES. In conclusion, the ESII is better calibrated than the logES at 30 days but does not represent a step forward in discrimination and global accuracy compared with its previous versions for predicting early- and long-term mortality of patients undergoing PCI.
本研究旨在对外验证经皮冠状动脉介入治疗(PCI)患者的欧洲心脏手术风险评估系统(EuroSCORE) II(ESII),并比较其与之前发布的加和型(addES)和 logistic EuroSCORE(logES)的性能。通过不同的区分度、校准和整体准确性测量方法分析了 537 例行 PCI 的患者。所有模型在 30 天、1 年和 5 年时的全因死亡率均呈梯度分布,除了 ESII 在 30 天时。与之前的版本相比,ESII 在所有时间点的受试者工作特征曲线下面积均最低,在 30 天时为 0.83(addES 和 logES 分别为 0.90),在 1 年时为 0.75(addES 和 logES 分别为 0.82),在 5 年时为 0.69(addES 为 0.77,logES 为 0.76)。然而,与 logES 相比,ESII 在 30 天时的校准更好,而在 1 年和 5 年时两个评分均存在校准不足。Brier 评分显示 ESII 和 logES 在整体准确性上相似。总之,与之前的版本相比,ESII 在 30 天时的校准更好,但在预测 PCI 患者的早期和长期死亡率方面,其在区分度和整体准确性方面并没有取得进步。