CardioCliniC Cologne, Cologne, Germany.
Eur J Cardiothorac Surg. 2013 Dec;44(6):992-7; discussion 997-8. doi: 10.1093/ejcts/ezt232. Epub 2013 Jun 11.
The purpose of this study was to develop a new scoring system for the prompt recognition of clinical deterioration and early treatment in postoperative cardiac surgical patients.
All consecutive adult patients undergoing cardiac surgery between 1st January 2007 and 31st December 2010 were included. The new score was calculated daily until intensive care unit (ICU) discharge. The score consists of 11 variables representing six different organ systems. Performance was assessed using receiver-operating characteristic (ROC) curves and calibration tests.
A total of 5207 patients with a mean age of 67.2 ± 10.9 years were admitted to the ICU after cardiac surgery. The operations performed covered the whole spectrum of cardiac surgery. ICU mortality was 5.9%. The mean length of ICU stay was 4.6 ± 7.0 days. The new score had an excellent discrimination with areas under the ROC curves between 0.91 and 0.96. Calibration was also excellent reflected by observed/expected mortality ratios ranging between 1.0 and 1.26.
The new score is a simple and reliable scoring system to assess organ dysfunction in cardiac intensive care patients. It is designed especially for personal digital assistants to simplify and accelerate the process of risk stratification in cardiac surgical ICUs.
本研究旨在开发一种新的评分系统，以便在心脏外科手术后患者中及时识别临床恶化并进行早期治疗。
纳入 2007 年 1 月 1 日至 2010 年 12 月 31 日期间连续进行心脏手术的所有成年患者。新评分每天计算一次，直至重症监护病房（ICU）出院。该评分由代表六个不同器官系统的 11 个变量组成。使用接收者操作特征（ROC）曲线和校准测试评估性能。
共有 5207 名平均年龄为 67.2 ± 10.9 岁的患者在心脏手术后入住 ICU。所进行的手术涵盖了心脏手术的整个范围。ICU 死亡率为 5.9%。ICU 住院时间平均为 4.6 ± 7.0 天。新评分具有出色的区分能力，ROC 曲线下面积在 0.91 至 0.96 之间。观察到的/预期的死亡率比值在 1.0 至 1.26 之间，这也反映了极好的校准。
新评分是一种简单而可靠的评分系统，可用于评估心脏重症监护患者的器官功能障碍。它专为个人数字助理设计，旨在简化和加速心脏外科 ICU 的风险分层过程。
