四种已建立的风险评分用于预测初次经皮冠状动脉介入治疗患者住院死亡率的比较分析。

IF 1.3
Rajesh Kumar, Iftikhar Ahmed, Lajpat Rai, Sanam Khowaja, Muhammad Hashim, Zille Huma, Jawaid Akbar Sial, Tahir Saghir, Nadeem Qamar, Musa Karim
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引用次数: 0

摘要

目的:本研究旨在比较休克指数(SI)、TIMI风险指数(TRI)、LASH评分和ACEF评分对发展中国家三级心脏保健中心接受初级经皮冠状动脉介入治疗(PCI)的st段抬高型心肌梗死(STEMI)患者的住院死亡率的预测能力。方法:连续诊断为STEMI并接受首次PCI的患者纳入本研究。计算SI、TRI、LASH和ACEF,并以受试者工作特征(ROC)曲线分析的曲线下面积(AUC)评估其对院内死亡率的预测能力。结果:纳入977例患者,其中男性780例(79.8%),平均年龄55.6±11.5岁。住院死亡率4.3%(42例)。TRI的AUC为0.669(最佳截止值:≥17.5,敏感性:76.2%,特异性:45.6%)。SI的AUC为0.595(最佳截止值:≥0.9,灵敏度:21.4%,特异性:89.8%)。LASH评分的AUC为0.745(最佳截止值≥0,敏感性76.2%,特异性66.9%)。ACEF评分的AUC为0.786(最佳截止值:≥1.66,敏感性:71.4%,特异性:73.5%)。结论:与其他三个评分相比,ACEF评分具有足够高的预测能力,具有良好的敏感性和特异性。这些基于易于获得的血流动力学参数的简化指标可以可靠地替代计算复杂的评分系统,用于STEMI患者的风险分层。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparative analysis of four established risk scores for prediction of in-hospital mortality in patients undergoing primary percutaneous coronary intervention.

Objective: This study was conducted to compare the predictive power of Shock Index (SI), TIMI Risk Index (TRI), LASH Score, and ACEF Score for the prediction of in-hospital mortality in a contemporary cohort of ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) at a tertiary care cardiac center of a developing country.

Methods: Consecutive patients diagnosed with STEMI and undergoing primary PCI were included in this study. SI, TRI, LASH, and ACEF were computed and their predictive power was assessed as the area under the curve (AUC) on the receiver operating characteristics (ROC) curve analysis for in-hospital mortality.

Results: We included 977 patients, 780 (79.8%) of which were male, and the mean age was 55.6 ± 11.5 years. The in-hospital mortality rate was 4.3% (42). AUC for TRI was 0.669 (optimal cutoff: ≥17.5, sensitivity: 76.2%, specificity: 45.6%). AUC for SI was 0.595 (optimal cutoff: ≥0.9, sensitivity: 21.4%, specificity: 89.8%). AUC for LASH score was 0.745 (optimal cutoff: ≥0, sensitivity: 76.2%, specificity: 66.9%). AUC for the ACEF score was 0.786 (optimal cutoff: ≥1.66, sensitivity: 71.4%, specificity: 73.5%).

Conclusion: In conclusion, ACEF showed sufficiently high predictive power with good sensitivity and specificity compared to other three scores. These simplified indices based on readily available hemodynamic parameters can be reliable alternatives to the computational complex scoring systems for the risk stratification of STEMI patients.

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来源期刊
American journal of cardiovascular disease
American journal of cardiovascular disease CARDIAC & CARDIOVASCULAR SYSTEMS-
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