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德国主动脉瓣评分在多外科医生单中心的验证

Validation of German Aortic Valve Score in a Multi-Surgeon Single Center.

作者信息

Kalender Mehmet, Baysal Ahmet Nihat, Karaca Okay Guven, Boyacioglu Kamil, Kayalar Nihan

机构信息

Konya Education Research Hospital, Cardiovascular Surgery Department, Konya, Turkey.

Duzce University Medical School Hospital, Cardiovascular Surgery Department, Duzce, Turkey.

出版信息

Braz J Cardiovasc Surg. 2017 Mar-Apr;32(2):77-82. doi: 10.21470/1678-9741-2016-0029.

Abstract

OBJECTIVE

: Risk assessment for operative mortality is mandatory for all cardiac operations. For some operation types such as aortic valve repair, EuroSCORE II overestimates the mortality rate and a new scoring system (German AV score) has been developed for a more accurate assessment of operative risk. In this study, we aimed to validate German Aortic Valve Score in our clinic in patients undergoing isolated aortic valve replacement.

METHODS

: A total of 35 patients who underwent isolated open aortic valve replacement between 2010 and 2013 were included. Patients with concomitant procedures and transcatheter aortic valve implantation were excluded. Patients' data were collected and analyzed retrospectively. Patients' risk scores EuroSCORE II were calculated online according to criteria described by EuroSCORE taskforce, Aortic Valve Scores were also calculated.

RESULTS

: The mean age of patients was 61.14±13.25 years (range 29-80 years). The number of female patients was 14 (40%) and body mass index of 25 (71.43%) patients was in range of 22-35. Mean German Aortic Valve Score was 1.05±0.96 (min: 0 max: 4.98) and mean EuroSCORE was 2.30±2.60 (min: 0.62, max: 2.30). The Aortic Valve Score scale showed better discriminative capacity (AUC 0.647, 95% CI 0.439-0.854). The goodness of fit was x2HL=16.63; P=0.436). EuroSCORE II scale had shown less discriminative capacity (AUC 0.397, 95% CI 0.200-0.597). The goodness of fit was good for both scales. The goodness of fit was x2HL=30.10; P=0.610.

CONCLUSION

: In conclusion, German AV score applies to our population with high predictive accuracy and goodness of fit.

摘要

目的

对所有心脏手术进行手术死亡率风险评估是必不可少的。对于某些手术类型,如主动脉瓣修复术,欧洲心脏手术风险评估系统(EuroSCORE)II高估了死亡率,因此开发了一种新的评分系统(德国主动脉瓣评分)以更准确地评估手术风险。在本研究中,我们旨在验证德国主动脉瓣评分在我院接受单纯主动脉瓣置换术患者中的有效性。

方法

纳入2010年至2013年间接受单纯开放性主动脉瓣置换术的35例患者。排除同期进行其他手术及经导管主动脉瓣植入术的患者。回顾性收集并分析患者数据。根据EuroSCORE工作组描述的标准在线计算患者的EuroSCORE II风险评分,同时也计算主动脉瓣评分。

结果

患者的平均年龄为61.14±13.25岁(范围29 - 80岁)。女性患者14例(40%),25例(71.43%)患者的体重指数在22 - 35之间。德国主动脉瓣评分的平均值为1.05±0.96(最小值:0,最大值:4.98),EuroSCORE的平均值为2.30±2.60(最小值:0.62,最大值:2.30)。主动脉瓣评分量表显示出更好的鉴别能力(曲线下面积[AUC]为0.647,95%置信区间[CI]为0.439 - 0.854)。拟合优度为x2HL = 16.63;P = 0.436)。EuroSCORE II量表显示出较低的鉴别能力(AUC为0.397,95% CI为0.200 - 0.597)。两种量表的拟合优度均良好。拟合优度为x2HL = 30.10;P = 0.610。

结论

总之,德国主动脉瓣评分在我们的人群中具有较高的预测准确性和拟合优度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1af/5409257/b080b443d575/rbccv-32-02-0077-g01.jpg

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