Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Beijing, 100053, China.
Tianjin University and Health-Biotech United Group Joint Laboratory of Innovative Drug Development and Translational Medicine, Tianjin University, Tianjin, 300072, China.
BMC Cardiovasc Disord. 2024 Sep 27;24(1):513. doi: 10.1186/s12872-024-04184-4.
This study aims to assess the performance of various scoring systems in predicting the 28-day mortality of patients with aortic aneurysms (AA) admitted to the intensive care unit (ICU).
We utilized data from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) to perform a comparative analysis of various predictive systems, including the Glasgow Aneurysm Score (GAS), Simplified Acute Physiology Score (SAPS) III, SAPS II, Logical Organ Dysfunction System (LODS), Sequential Organ Failure Assessment (SOFA), Systemic Inflammatory Response Syndrome (SIRS), and The Oxford Acute Illness Severity Score (OASIS). The discrimination abilities of these systems were compared using the area under the receiver operating characteristic curve (AUROC). Additionally, a 4-knotted restricted cubic spline regression was employed to evaluate the association between the different scoring systems and the risk of 28-day mortality. Finally, we conducted a subgroup analysis focusing on patients with abdominal aortic aneurysms (AAA).
This study enrolled 586 patients with AA (68.39% male). Among them, 26 patients (4.4%) died within 28 days. Comparative analysis revealed higher SAPS II, SAPS III, SOFA, LODS, OASIS, and SIRS scores in the deceased group, while no statistically significant difference was observed in GAS scores between the survivor and deceased groups (P = 0.148). The SAPS III system exhibited superior predictive value for the 28-day mortality rate (AUROC 0.805) compared to the LODS system (AUROC 0.771), SOFA (AUROC 0.757), SAPS II (AUROC 0.759), OASIS (AUROC 0.742), SIRS (AUROC 0.638), and GAS (AUROC 0.586) systems. The results of the univariate and multivariate logistic analyses showed that SAPS III was statistically significant for both 28-day and 1-year mortality. Subgroup analyses yielded results consistent with the overall findings. No nonlinear relationship was identified between these scoring systems and 28-day all-cause mortality (P for nonlinear > 0.05).
The SAPS III system demonstrated superior discriminatory ability for both 28-day and 1-year mortality compared to the GAS, SAPS II SIRS, SOFA, and OASIS systems among patients with AA.
本研究旨在评估各种评分系统在预测入住重症监护病房（ICU）的主动脉瘤（AA）患者 28 天死亡率方面的表现。
我们利用医疗信息集市重症监护 IV 版（MIMIC-IV）的数据，对各种预测系统进行了对比分析，包括格拉斯哥动脉瘤评分（GAS）、简化急性生理学评分（SAPS）III、SAPS II、逻辑器官功能障碍系统（LODS）、序贯器官衰竭评估（SOFA）、全身炎症反应综合征（SIRS）和牛津急性疾病严重程度评分（OASIS）。使用受试者工作特征曲线下面积（AUROC）比较这些系统的鉴别能力。此外，还采用 4 结限制立方样条回归评估了不同评分系统与 28 天死亡率风险之间的关联。最后，我们进行了亚组分析，重点关注腹主动脉瘤（AAA）患者。
本研究共纳入 586 例 AA 患者（68.39%为男性）。其中，26 例（4.4%）患者在 28 天内死亡。比较分析显示，死亡组的 SAPS II、SAPS III、SOFA、LODS、OASIS 和 SIRS 评分较高，而存活组和死亡组之间的 GAS 评分无统计学差异（P=0.148）。SAPS III 系统对 28 天死亡率的预测价值优于 LODS 系统（AUROC 0.805 对 0.771）、SOFA（AUROC 0.757）、SAPS II（AUROC 0.759）、OASIS（AUROC 0.742）、SIRS（AUROC 0.638）和 GAS（AUROC 0.586）系统。单因素和多因素逻辑分析的结果表明，SAPS III 对 28 天和 1 年死亡率均具有统计学意义。亚组分析结果与总体结果一致。这些评分系统与 28 天全因死亡率之间未发现非线性关系（P 非线性>0.05）。
与 GAS、SAPS II、SIRS、SOFA 和 OASIS 系统相比，SAPS III 系统在预测 AA 患者 28 天和 1 年死亡率方面具有更好的鉴别能力。
