TIMI 风险评分在预测老年女性经皮冠状动脉介入治疗后死亡率中的表现：来自发展中国家的结果。
Performance of the TIMI risk score in predicting mortality after primary percutaneous coronary intervention in elderly women: Results from a developing country.
机构信息
Department of Research, National Institute of Cardiovascular Diseases, Karachi, Pakistan.
Department of Medicine, Ziauddin Medical University, Karachi, Pakistan.
出版信息
PLoS One. 2019 Jul 25;14(7):e0220289. doi: 10.1371/journal.pone.0220289. eCollection 2019.
BACKGROUND
Despite women undergoing primary percutaneous coronary intervention (PPCI) having a higher rate of adverse outcomes than men, data evaluating prognostic risk scores, especially in elderly women, remains scarce. This study was conducted to validate the predictive value of Thrombolysis in Myocardial Infarction (TIMI) risk score in elderly female patients.
MATERIALS AND METHODS
This was a retrospective analysis of elderly (>65 years) female patients who underwent PPCI for ST-elevated myocardial infarction (STEMI) from October 2016 to September 2018. Patients' demographic details and elements of TIMI risk score including age, co-morbidities, Killip classification; weight, anterior MI and total ischemic time were extracted from hospital records. The primary outcome was in-hospital mortality and post-discharge mortality reported on telephonic follow-up.
RESULTS
A total of 404 elderly women with a median age of 70 years were included. The mean TIMI score was 5.25±1.45 with 40.3% (163) patients of TIMI score > 5. In-hospital mortality rate was 6.4% (26) and was found to be associated with TIMI score (p<0.001). The in-hospital mortality rate increased from 3.1% at TIMI score of 0-4 to 34.6% at the score of 8. On follow-up (16.43±7.40 months) of 211 (55.8%) patients, the overall mortality rate was 20.3%, and this was also associated with TIMI score (p<0.001). The mortality rate increased from 5.6% at the score of 0-4 to 54.5% at the score of 8. The predictive values (area under the curve) of TIMI risk score for in-hospital and post-discharge mortality were 0.709 (95% CI 0.591-0.827; p <0.001) and 0.689 (95% CI 0.608-0.770; p <0.001), respectively.
CONCLUSION
Increased adverse outcomes were observed with higher TIMI risk score for in hospital and post-discharge follow-up. Therefore, the prognostic TIMI risk score is a robust tool in predicting both in-hospital as well as post-discharge mortality in elderly females.
背景
尽管女性接受经皮冠状动脉介入治疗（PPCI）的不良结局发生率高于男性，但评估预后风险评分的数据，尤其是在老年女性中，仍然很少。本研究旨在验证血栓溶解在心肌梗死（TIMI）风险评分在老年女性患者中的预测价值。
材料和方法
这是一项回顾性分析，纳入了 2016 年 10 月至 2018 年 9 月期间因 ST 段抬高型心肌梗死（STEMI）接受 PPCI 的年龄>65 岁的老年女性患者。从病历中提取患者的人口统计学细节和 TIMI 风险评分的要素，包括年龄、合并症、Killip 分级；体重、前壁心肌梗死和总缺血时间。主要结局是院内死亡率和出院后死亡率，通过电话随访报告。
结果
共纳入 404 名年龄中位数为 70 岁的老年女性。平均 TIMI 评分为 5.25±1.45，其中 40.3%（163）患者的 TIMI 评分>5。院内死亡率为 6.4%（26），与 TIMI 评分相关（p<0.001）。TIMI 评分为 0-4 时，院内死亡率为 3.1%，评分为 8 时，死亡率为 34.6%。在 211 名（55.8%）接受随访（16.43±7.40 个月）的患者中，总死亡率为 20.3%，与 TIMI 评分相关（p<0.001）。TIMI 评分从 0-4 时的 5.6%增加到 8 时的 54.5%。TIMI 风险评分对院内和出院后死亡率的预测值（曲线下面积）分别为 0.709（95%置信区间 0.591-0.827；p<0.001）和 0.689（95%置信区间 0.608-0.770；p<0.001）。
结论
TIMI 风险评分较高的患者在院内和出院后随访中观察到不良结局增加。因此，预后 TIMI 风险评分是预测老年女性患者院内和出院后死亡率的可靠工具。
Zotero 插件