Tiveron Marcos Gradim, Bomfim Helton Augusto, Simplício Maycon Soto, Bergonso Marcos Henriques, Matos Milena Paiva Brasil de, Ferreira Sergio Marques, Pelloso Eraldo Antônio, Barros Rubens Tofano de
Irmandade da Santa Casa de Misericórdia de Marília, Marília, SP, Brazil.
Rev Bras Cir Cardiovasc. 2015 Jan-Mar;30(1):1-8. doi: 10.5935/1678-9741.20140116.
To apply and to compare the Society of Thoracic Surgery score (STS), EuroSCORE (Eurosc1), EuroSCORE II (Eurosc2) and InsCor (IS) for predicting mortality in patients undergoing to coronary artery bypass graft and/or valve surgery at the Santa Casa Marilia.
The present study is a cohort. It is a prospective, observational, analytical and unicentric. We analyzed 562 consecutive patients coronary artery bypass graft and/or valve surgery, between April 2011 and June 2013 at the Santa Casa Marilia. Mortality was calculated for each patient through the scores STS, Eurosc1, Eurosc2 and IS. The calibration was calculated using the Hosmer Lemeshow test and discrimination by ROC curve.
The hospital mortality was 4,6%. The calibration is generally adequate group P=0.345, P=0.765, P=0.272 and P=0.062 for STS, Eurosc1, Eurosc2, and IS respectively. The discriminatory power of STS score 0.649 (95% CI 0.529 to 0.770, P=0.012), Eurosc1 0.706 (95% CI 0.589 to 0.823, P ≤0.001), Eurosc2 was 0.704 (95% CI 0.590-0.818 P=0.001) and InsCor 0.739 (95% CI 0.638 to 0.839, P ≤0.001).
We can say that overall, the InsCor was the best model, mainly in the discrimination of the sample. The InsCor showed good accuracy, in addition to being effective and easy to apply, especially by using a smaller number of variables compared to the other models.
应用并比较胸外科医师协会评分（STS）、欧洲心脏手术风险评估系统（EuroSCORE，Eurosc1）、欧洲心脏手术风险评估系统Ⅱ（EuroSCORE II，Eurosc2）和InsCor（IS），以预测在圣卡桑马里利亚医院接受冠状动脉旁路移植术和/或瓣膜手术患者的死亡率。
本研究为队列研究。它是前瞻性、观察性、分析性和单中心的。我们分析了2011年4月至2013年6月期间在圣卡桑马里利亚医院连续接受冠状动脉旁路移植术和/或瓣膜手术的562例患者。通过STS、Eurosc1、Eurosc2和IS评分计算每位患者的死亡率。使用Hosmer Lemeshow检验计算校准度，并通过ROC曲线进行鉴别分析。
医院死亡率为4.6%。校准度总体上是合适的，STS、Eurosc1、Eurosc2和IS的P值分别为0.345、0.765、0.272和0.062。STS评分的鉴别力为0.649（95%可信区间0.529至0.770，P = 0.012），Eurosc1为0.706（95%可信区间0.589至0.823，P≤0.001），Eurosc2为0.704（95%可信区间0.590 - 0.818，P = 0.001），InsCor为0.739（95%可信区间0.638至0.839，P≤0.001）。
总体而言，我们可以说InsCor是最佳模型，主要体现在对样本的鉴别方面。InsCor除了有效且易于应用外，还具有良好的准确性，特别是与其他模型相比，它使用的变量数量更少。
