Shen Li, Chen Xi, Gu Jianming, Xue Song
Department of Cardiovascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Heart Surg Forum. 2018 Jan 31;21(1):E036-E039. doi: 10.1532/hsf.1710.
Comparisons between the EuroSCORE and EuroSCORE II in the patient populations for coronary artery bypass grafting are limited. The aim of the study was to compare the use of the EuroSCORE and EuroSCORE II as risk model for predicting in-hospital mortality in Chinese patients undergoing coronary artery bypass grafting (CABG).
Patients (n = 1598) with complete records of baseline and operative data were retrospectively collected from computerized records. The expected mortality rate for logistic EuroSCORE and EuroSCORE II was determined. Performance of the logistic EuroSCORE and EuroSCORE II model was assessed by comparing the observed and expected in-hospital mortality. The area under the receiver operating characteristics curve (AUC) values were calculated for these models to compare predictive power.
Observed in-hospital overall mortality rate was 3.19%. The logistic EuroSCORE model (Hosmer-Lemeshow: P < .05, O/E = 0.73) over-predicted mortality (4.39%) and the EuroSCORE II model showed good calibration and discriminative capacity (area 0.762) in predicting in-hospital mortality (Hosmer-Lemeshow: P = .191, O/E = 1.24).
EuroSCORE II model reduces the overestimation of the calculated risk by logistic EuroSCORE in this population. EuroSCORE II risk model may be suitable in patients undergoing coronary artery bypass surgery in China.
在冠状动脉搭桥手术患者群体中,欧洲心脏手术风险评估系统(EuroSCORE)与第二代欧洲心脏手术风险评估系统(EuroSCORE II)之间的比较有限。本研究的目的是比较EuroSCORE和EuroSCORE II作为预测中国冠状动脉搭桥手术(CABG)患者院内死亡率风险模型的应用情况。
从计算机记录中回顾性收集1598例有完整基线和手术数据记录的患者。确定逻辑EuroSCORE和EuroSCORE II的预期死亡率。通过比较观察到的和预期的院内死亡率来评估逻辑EuroSCORE和EuroSCORE II模型的性能。计算这些模型的受试者工作特征曲线(AUC)下面积值以比较预测能力。
观察到的院内总死亡率为3.19%。逻辑EuroSCORE模型(Hosmer-Lemeshow检验:P < 0.05,观察值/预期值 = 0.73)高估了死亡率(4.39%),而EuroSCORE II模型在预测院内死亡率方面显示出良好的校准和鉴别能力(面积为0.762)(Hosmer-Lemeshow检验:P = 0.191,观察值/预期值 = 1.24)。
在该人群中,EuroSCORE II模型减少了逻辑EuroSCORE对计算风险的高估。EuroSCORE II风险模型可能适用于中国接受冠状动脉搭桥手术的患者。