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巴西的年龄、肌酐和射血分数评分：与InsCor及欧洲心脏手术风险评估系统（EuroSCORE）的比较。

Age, Creatinine and Ejection Fraction Score in Brazil: Comparison with InsCor and the EuroSCORE.

作者信息

Mejía Omar Asdrúbal Vilca, Matrangolo Bruna La Regina, Titinger David Provenzale, Faria Leandro Batisti de, Dallan Luís Roberto Palma, Galas Filomena Regina Barbosa, Lisboa Luiz Augusto Ferreira, Dallan Luís Alberto Oliveira, Jatene Fabio Biscegli

机构信息

Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.

出版信息

Arq Bras Cardiol. 2015 Nov;105(5):450-6. doi: 10.5935/abc.20150101. Epub 2015 Aug 25.

DOI:10.5935/abc.20150101
PMID:26312550
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4651402/
Abstract

BACKGROUND

Risk scores for cardiac surgery cannot continue to be neglected.

OBJECTIVE

To assess the performance of "Age, Creatinine and Ejection Fraction Score" (ACEF Score) to predict mortality in patients submitted to elective coronary artery bypass graft and/or heart valve surgery, and to compare it to other scores.

METHODS

A prospective cohort study was carried out with the database of a Brazilian tertiary care center. A total of 2,565 patients submitted to elective surgeries between May 2007 and July 2009 were assessed. For a more detailed analysis, the ACEF Score performance was compared to the InsCor's and EuroSCORE's performance through correlation, calibration and discrimination tests.

RESULTS

Patients were stratified into mild, moderate and severe for all models. Calibration was inadequate for ACEF Score (p = 0.046) and adequate for InsCor (p = 0.460) and EuroSCORE (p = 0.750). As for discrimination, the area under the ROC curve was questionable for the ACEF Score (0.625) and adequate for InsCor (0.744) and EuroSCORE (0.763).

CONCLUSION

Although simple to use and practical, the ACEF Score, unlike InsCor and EuroSCORE, was not accurate for predicting mortality in patients submitted to elective coronary artery bypass graft and/or heart valve surgery in a Brazilian tertiary care center.

摘要

背景

心脏手术的风险评分不容忽视。

目的

评估“年龄、肌酐和射血分数评分”（ACEF评分）在预测接受择期冠状动脉搭桥术和/或心脏瓣膜手术患者死亡率方面的表现，并将其与其他评分进行比较。

方法

利用巴西一家三级护理中心的数据库进行了一项前瞻性队列研究。对2007年5月至2009年7月期间接受择期手术的2565例患者进行了评估。为进行更详细的分析，通过相关性、校准和区分度测试，将ACEF评分的表现与InsCor评分和欧洲心脏手术风险评估系统（EuroSCORE）的表现进行了比较。

结果

所有模型的患者均被分为轻度、中度和重度。ACEF评分校准不足（p = 0.046），InsCor评分校准良好（p = 0.460），欧洲心脏手术风险评估系统校准良好（p = 0.750）。至于区分度，ACEF评分的ROC曲线下面积存疑（0.625），InsCor评分（0.744）和欧洲心脏手术风险评估系统（0.763）的区分度良好。

结论

尽管ACEF评分使用简单且实用，但与InsCor评分和欧洲心脏手术风险评估系统不同，在巴西一家三级护理中心，它在预测接受择期冠状动脉搭桥术和/或心脏瓣膜手术患者的死亡率方面并不准确。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8daa/4651402/6e44749b3934/abc-105-05-0450-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8daa/4651402/6e44749b3934/abc-105-05-0450-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8daa/4651402/6e44749b3934/abc-105-05-0450-g01.jpg

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Heart surgery programs innovation using surgical risk stratification at the São Paulo State Public Healthcare System: SP-SCORE-SUS study.
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