Samy A K, Murray G, MacBain G
General Surgical Unit, Southern General Hospital, Glasgow, UK.
Cardiovasc Surg. 1994 Feb;2(1):41-4.
A clinical prognostic scoring system for patients with abdominal aortic aneurysm and audit of the sequelae of a sample population in Glasgow, are described. Randomly selected case notes of 500 patients, representing 41.6% (500 of 1202) of the total population treated in Glasgow hospitals with general surgical units (as opposed to vascular units) between 1980 and 1990, were examined for risk factors. These were then related to the operative and postoperative hospital mortality. Initial univariate analysis showed the outcome to be significantly influenced by the following factors: age (P = < 0.01), rupture (P = < 0.001), shock (P = < 0.001), myocardial disease (P = 0.08), cerebrovascular disease (P = 0.03), renal disease (P = 0.03) and size of the aneurysm (P = 0.06). Using multivariate analysis, the following independent risk factors were identified: age (P = 0.02), shock (P = < 0.001), myocardial disease (P = 0.02), cerebrovascular disease (P = 0.02) and renal disease (P = 0.003). Rounding of the regression coefficients created a simple risk score: risk score = (age in years)+(17 for shock)+(7 for myocardial disease)+(10 for cerebrovascular disease)+(14 for renal disease). Subsequent evaluation of the scoring system showed that the mortality rate increases in proportion to the score. Other findings are analysed and discussed.
本文描述了一种针对腹主动脉瘤患者的临床预后评分系统，并对格拉斯哥一个样本群体的后遗症进行了审计。对1980年至1990年间在格拉斯哥医院普通外科病房（而非血管外科病房）接受治疗的全部患者中随机抽取的500例病例记录（占总数的41.6%，即1202例中的500例）进行了危险因素检查。然后将这些因素与手术及术后医院死亡率相关联。初始单因素分析显示，以下因素对结果有显著影响：年龄（P = < 0.01）、破裂（P = < 0.001）、休克（P = < 0.001）、心肌病（P = 0.08）、脑血管疾病（P = 0.03）、肾脏疾病（P = 0.03）和动脉瘤大小（P = 0.06）。使用多因素分析，确定了以下独立危险因素：年龄（P = 0.02）、休克（P = < 0.001）、心肌病（P = 0.02）、脑血管疾病（P = 0.02）和肾脏疾病（P = 0.003）。回归系数的四舍五入产生了一个简单的风险评分：风险评分 =（年龄）+（休克为17）+（心肌病为7）+（脑血管疾病为10）+（肾脏疾病为14）。随后对评分系统的评估表明，死亡率随评分成比例增加。对其他发现进行了分析和讨论。
