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欧洲心脏手术风险评估系统II(EuroSCORE II)和胸外科医师协会评分在接受主动脉瓣置换术治疗主动脉狭窄患者中的表现。

Performance of the EuroSCORE II and the Society of Thoracic Surgeons score in patients undergoing aortic valve replacement for aortic stenosis.

作者信息

Duchnowski Piotr, Hryniewiecki Tomasz, Kuśmierczyk Mariusz, Szymanski Piotr

机构信息

Institute of Cardiology, Department of Acquired Cardiac Defects, Warsaw, Poland.

Institute of Cardiology, Department of Cardiosurgery and Transplantology, Warsaw, Poland.

出版信息

J Thorac Dis. 2019 May;11(5):2076-2081. doi: 10.21037/jtd.2019.04.48.

Abstract

BACKGROUND

The aim of the study was to assess the predictive ability of risk calculators of the EuroSCORE II and the Society of Thoracic Surgeons (STS) score in patients undergoing aortic valve replacement (AVR) due to severe aortic valve stenosis (AS) during a 30-day and 1-year follow-up.

METHODS

A prospective study was conducted on a group of consecutive patients with hemodynamically significant aortic valve stenosis that underwent elective valve replacement surgery. The risk of surgery using EuroSCORE II and STS was calculated for each patient. The primary and secondary endpoints were 30-day and 1-year mortality.

RESULTS

The study group included 428 consecutive patients who underwent replacement of the aortic valve. Thirteen patients died during the 30-day follow-up and 25 patients died during 1-year follow-up. Actual mortality in 30-day observation was 3.0% compared to the predicted 2.9% using EuroSCORE II and 2.1% for STS. The discriminations of ES II and STS score were above 0.8 for mortality prediction during the 30-day and 1-year observation period.

CONCLUSIONS

The EuroSCORE II and STS score showed satisfactory discrimination and calibration for predicting 30-day and 1-year mortality in patients undergoing AVR.

摘要

背景

本研究旨在评估欧洲心脏手术风险评估系统Ⅱ(EuroSCORE II)和胸外科医师协会(STS)评分风险计算器对因严重主动脉瓣狭窄(AS)接受主动脉瓣置换术(AVR)患者在30天和1年随访期间的预测能力。

方法

对一组连续的有血流动力学意义的主动脉瓣狭窄患者进行前瞻性研究,这些患者接受了择期瓣膜置换手术。为每位患者计算使用EuroSCORE II和STS的手术风险。主要和次要终点分别为30天和1年死亡率。

结果

研究组包括428例连续接受主动脉瓣置换的患者。13例患者在30天随访期间死亡,25例患者在1年随访期间死亡。30天观察期的实际死亡率为3.0%,而使用EuroSCORE II预测的死亡率为2.9%,使用STS预测的死亡率为2.1%。在30天和1年观察期内,ES II和STS评分对死亡率预测的鉴别能力均高于0.8。

结论

EuroSCORE II和STS评分在预测接受AVR患者的30天和1年死亡率方面显示出令人满意的鉴别能力和校准能力。

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