目的 評(píng)價(jià)中國(guó)冠狀動(dòng)脈旁路移植手術(shù)風(fēng)險(xiǎn)評(píng)估系統(tǒng)(Sino System for Coronary Operative Risk Evaluation,SinoSCORE) 對(duì)華西醫(yī)院(本中心)成人心臟手術(shù)后院內(nèi)死亡風(fēng)險(xiǎn)的預(yù)測(cè)價(jià)值?!》椒ā∵B續(xù)納入2010年1月至2012年5月進(jìn)入中國(guó)成人心臟外科數(shù)據(jù)庫(kù)、本中心2 088例行心臟手術(shù)患者的臨床資料,比較本中心與中國(guó)成人心臟外科數(shù)據(jù)庫(kù)中所有患者術(shù)前危險(xiǎn)因素的差異。計(jì)算每例患者的SinoSCORE累計(jì)積分,評(píng)價(jià)SinoSCORE預(yù)測(cè)本中心患者院內(nèi)死亡風(fēng)險(xiǎn)的鑒別度和校準(zhǔn)度。 結(jié)果 本中心2 088例患者中行冠狀動(dòng)脈旁路移植術(shù)(CABG) 168例(8.05%),心瓣膜手術(shù)1 884例(90.23%),其它手術(shù)36例(1.72%)。本中心患者的高脂血癥、腦卒中、心血管手術(shù)史、腎臟疾病等與中國(guó)成人心臟外科數(shù)據(jù)庫(kù)中全部患者的差異有統(tǒng)計(jì)學(xué)意義。本中心患者實(shí)際術(shù)后院內(nèi)病死率為2.25% (47/2 088),SinoSCORE預(yù)測(cè)院內(nèi)病死率為2.35% (49/2 088)[95% CI (2.18,2.47)]。SinoSCORE預(yù)測(cè)本中心患者術(shù)后院內(nèi)病死率的校準(zhǔn)度(χ2=3.164, P=0.582)和鑒別度[受試者工作特征曲線下面積0.751,95% CI (0.719,0.924)] 均較好?!〗Y(jié)論 SinoSCORE對(duì)中國(guó)西南地區(qū)成人心臟手術(shù)后院內(nèi)死亡風(fēng)險(xiǎn)的預(yù)測(cè)雖高估風(fēng)險(xiǎn),但仍適用。

引用本文: 錢(qián)永軍,張爾永,安琪,肖錫俊,楊建,董力,郭應(yīng)強(qiáng),賃可. SinoSCORE對(duì)成人心臟手術(shù)后院內(nèi)死亡風(fēng)險(xiǎn)的預(yù)測(cè)——中國(guó)成人心臟外科數(shù)據(jù)庫(kù)華西醫(yī)院數(shù)據(jù)報(bào)告. 中國(guó)胸心血管外科臨床雜志, 2012, 19(4): 362-365. doi: 復(fù)制

1. operative risk for Chinese population? Eur J Cardiothorac Surg, 2009, 35 (1):54-58.
2.  江學(xué)成. 手術(shù)風(fēng)險(xiǎn)預(yù)測(cè)方法解讀. 中國(guó)實(shí)用外科雜志, 2007, 27(9):746-749.
3.  鄭哲, 張路, 胡盛壽, 代表中國(guó)心血管外科注冊(cè)登記協(xié)作組. 中國(guó)冠狀動(dòng)脈旁路移植手術(shù)風(fēng)險(xiǎn)評(píng)估系統(tǒng). 中華心血管病雜志, 2010, 26 (10):901-904.
4.  Nashef S, Roques F, Michel P, et al. European system for cardiacoperative risk evaluation(EuroSCORE).Eur J Cardiothorac Surg, 1999, 16 (1):9-13.
5.  Roques F, Nashef SA, Michel P, et al. Risk factors and outcome in European cardiac surgery:analysis of the EuroSCORE multinational database of 19030 patients. Eur J Cardiothorac Surg, 1999, 15 (6):816-822.
6.  Nashef S, Roques F, Hammill BG, et al. Validation of European System for Cardiac Operative Risk Evaluation(EuroSCORE)in North American cardiac surgery.Eur J Cardiothorac Surg, 2002, 22 (1):101-105.
7.  Zheng Z, Li Y, Zhang S, et al. The Chinese coronary artery bypass grafting registry study:how well does the EuroSCORE predict.
8.  Li Y, Zheng Z, Hu S, et al. The Chinese coronary artery bypass grafting registry study:analysis of the national multicentre database of 9248 patients. Heart, 2009, 95 (14):1140-1144.
9.  Zingone B, Pappalardo A, Dreas L. Logistic versus additive EuroSCORE. A comparative assessment of the two models in all independent population sample. Eur J Cardiothorac Surg, 2004, 26 (6):1134-1140.
10.  Choong CK, Sergeant P, Nashef SA, et al. The EuroSCORE risk stratification system in the current era:how accurate is it and what should be done if it is inaccurate? Eur J Cardiothorac Surg, 2009, 35 (1):59-61.
11.  Ghazy T, Dappert U, Ouda A, et al. A question of clinical reliability:observed versus EuroSCORE-predicted mortality after aortic valve replacement. J Heart Valve Dis, 2010, 19 (1):16-20.
12.  Holinski S, Claus B, Christ T, et al. Overestimation of the operative risk by the EuroSCORE also in high-risk patients undergoing aortic valve replacement with a stentless biological prosthesis. Heart Surg Forum, 2010, 13 (1):E13-E16.
13.  Parolari A, Pesce LL, Trezzi M, et al. EuroSCORE performance in valve surgery:a meta-analysis. Ann Thorac Surg, 2010, 89 (3):787-793.
14.  郭惠明, 吳若彬, 肖學(xué)鈞. SinoSCORE預(yù)測(cè)心血管外科手術(shù)病死率. 中華胸心血管外科雜志, 2011, 27 (2):78-80.
15.  Wang C, Yao F, Han L, et al. Validation of the European system for cardiac operative risk evaluation (EuroSCORE) in Chinese heart valve surgery patients. J Heart Valve Dis, 2010, 19 (1):21-27.
16.  葛翼鵬, 許建屏, 孫立忠. 歐洲心臟手術(shù)風(fēng)險(xiǎn)評(píng)估系統(tǒng)預(yù)測(cè)中國(guó)人心瓣膜手術(shù)后并發(fā)癥的發(fā)生及預(yù)后. 中國(guó)胸心血管外科臨床雜志, 2010, 17 (5):357-360.
17.  Hanley JA, Mcneil BJ. The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology, 1982, 143 (1):29-36.
18.  Kawachi Y, Nakashima A, Toshima Y, et al. Risk stratification analysis of operative mortality in heart and thoracic aorta surgery:comparison between Parsonnet and EuroSCORE additive model. Eur J Cardiothorac Surg, 2001, 20 (5):961-966.
19.  Kawachi Y, Nakashima A, Toshima Y, et al. Evaluation of the quality of cardiovascular surgery care using risk stratification analysis according to the EuroSCORE additive model. Circ J, 2002, 66 (2):145-148.
20.  Bhatti F, Grayson AD, Grotte G, et al. The logistic EuroSCORE in cardiac surgery:how well does it predict operative risk? Heart, 2006, 92 (12):1817-1820.
21.  Yap CH, Reid C, Yii M, et al. Validation of the EuroSCORE model in Australia. Eur J Cardiothorac Surg, 2006, 29 (4):441-446.
  1. 1. operative risk for Chinese population? Eur J Cardiothorac Surg, 2009, 35 (1):54-58.
  2. 2.  江學(xué)成. 手術(shù)風(fēng)險(xiǎn)預(yù)測(cè)方法解讀. 中國(guó)實(shí)用外科雜志, 2007, 27(9):746-749.
  3. 3.  鄭哲, 張路, 胡盛壽, 代表中國(guó)心血管外科注冊(cè)登記協(xié)作組. 中國(guó)冠狀動(dòng)脈旁路移植手術(shù)風(fēng)險(xiǎn)評(píng)估系統(tǒng). 中華心血管病雜志, 2010, 26 (10):901-904.
  4. 4.  Nashef S, Roques F, Michel P, et al. European system for cardiacoperative risk evaluation(EuroSCORE).Eur J Cardiothorac Surg, 1999, 16 (1):9-13.
  5. 5.  Roques F, Nashef SA, Michel P, et al. Risk factors and outcome in European cardiac surgery:analysis of the EuroSCORE multinational database of 19030 patients. Eur J Cardiothorac Surg, 1999, 15 (6):816-822.
  6. 6.  Nashef S, Roques F, Hammill BG, et al. Validation of European System for Cardiac Operative Risk Evaluation(EuroSCORE)in North American cardiac surgery.Eur J Cardiothorac Surg, 2002, 22 (1):101-105.
  7. 7.  Zheng Z, Li Y, Zhang S, et al. The Chinese coronary artery bypass grafting registry study:how well does the EuroSCORE predict.
  8. 8.  Li Y, Zheng Z, Hu S, et al. The Chinese coronary artery bypass grafting registry study:analysis of the national multicentre database of 9248 patients. Heart, 2009, 95 (14):1140-1144.
  9. 9.  Zingone B, Pappalardo A, Dreas L. Logistic versus additive EuroSCORE. A comparative assessment of the two models in all independent population sample. Eur J Cardiothorac Surg, 2004, 26 (6):1134-1140.
  10. 10.  Choong CK, Sergeant P, Nashef SA, et al. The EuroSCORE risk stratification system in the current era:how accurate is it and what should be done if it is inaccurate? Eur J Cardiothorac Surg, 2009, 35 (1):59-61.
  11. 11.  Ghazy T, Dappert U, Ouda A, et al. A question of clinical reliability:observed versus EuroSCORE-predicted mortality after aortic valve replacement. J Heart Valve Dis, 2010, 19 (1):16-20.
  12. 12.  Holinski S, Claus B, Christ T, et al. Overestimation of the operative risk by the EuroSCORE also in high-risk patients undergoing aortic valve replacement with a stentless biological prosthesis. Heart Surg Forum, 2010, 13 (1):E13-E16.
  13. 13.  Parolari A, Pesce LL, Trezzi M, et al. EuroSCORE performance in valve surgery:a meta-analysis. Ann Thorac Surg, 2010, 89 (3):787-793.
  14. 14.  郭惠明, 吳若彬, 肖學(xué)鈞. SinoSCORE預(yù)測(cè)心血管外科手術(shù)病死率. 中華胸心血管外科雜志, 2011, 27 (2):78-80.
  15. 15.  Wang C, Yao F, Han L, et al. Validation of the European system for cardiac operative risk evaluation (EuroSCORE) in Chinese heart valve surgery patients. J Heart Valve Dis, 2010, 19 (1):21-27.
  16. 16.  葛翼鵬, 許建屏, 孫立忠. 歐洲心臟手術(shù)風(fēng)險(xiǎn)評(píng)估系統(tǒng)預(yù)測(cè)中國(guó)人心瓣膜手術(shù)后并發(fā)癥的發(fā)生及預(yù)后. 中國(guó)胸心血管外科臨床雜志, 2010, 17 (5):357-360.
  17. 17.  Hanley JA, Mcneil BJ. The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology, 1982, 143 (1):29-36.
  18. 18.  Kawachi Y, Nakashima A, Toshima Y, et al. Risk stratification analysis of operative mortality in heart and thoracic aorta surgery:comparison between Parsonnet and EuroSCORE additive model. Eur J Cardiothorac Surg, 2001, 20 (5):961-966.
  19. 19.  Kawachi Y, Nakashima A, Toshima Y, et al. Evaluation of the quality of cardiovascular surgery care using risk stratification analysis according to the EuroSCORE additive model. Circ J, 2002, 66 (2):145-148.
  20. 20.  Bhatti F, Grayson AD, Grotte G, et al. The logistic EuroSCORE in cardiac surgery:how well does it predict operative risk? Heart, 2006, 92 (12):1817-1820.
  21. 21.  Yap CH, Reid C, Yii M, et al. Validation of the EuroSCORE model in Australia. Eur J Cardiothorac Surg, 2006, 29 (4):441-446.