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首页> 外文期刊>Medical Science Monitor Basic Research >Combination of European System for Cardiac Operative Risk Evaluation (EuroSCORE) and Cardiac Surgery Score (CASUS) to Improve Outcome Prediction in Cardiac Surgery
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Combination of European System for Cardiac Operative Risk Evaluation (EuroSCORE) and Cardiac Surgery Score (CASUS) to Improve Outcome Prediction in Cardiac Surgery

机译：欧洲心脏手术风险评估系统（EuroSCORE）和心脏手术评分（CASUS）的结合，以改善心脏手术的结果预测

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BACKGROUND We hypothesized that the combination of a preoperative and a postoperative scoring system would improve the accuracy of mortality prediction and therefore combined the preoperative ‘additive EuroSCORE‘ (European system for cardiac operative risk evaluation) with the postoperative ‘additive CASUS’ (Cardiac Surgery Score) to form the ‘modified CASUS’. MATERIAL AND METHODS We included all consecutive adult patients after cardiac surgery during January 2007 and December 2010 in our prospective study. Our single-centre study was conducted in a German general referral university hospital. The original additive and the ‘modified CASUS’ were tested using calibration and discrimination statistics. We compared the area under the curve (AUC) of the receiver characteristic curves (ROC) by DeLong’s method and calculated overall correct classification (OCC) values. RESULTS The mean age among the total of 5207 patients was 67.2±10.9 years. Whilst the ICU mortality was 5.9% we observed a mean length of ICU stay of 4.6±7.0 days. Both models demonstrated excellent discriminatory power (mean AUC of ‘modified CASUS’: ≥0.929; ‘additive CASUS’: ≥0.920), with no significant differences according to DeLong. Neither model showed a significant p-value (<0.05) in calibration. We detected the best OCC during the 2nd day (modified: 96.5%; original: 96.6%). CONCLUSIONS Our ‘additive’ and ‘modified’ CASUS are reasonable overall predictors. We could not detect any improvement in the accuracy of mortality prediction in cardiac surgery by combining a preoperative and a postoperative scoring system. A separate calculation of the two individual elements is therefore recommended.
机译：背景我们假设术前和术后评分系统的组合将提高死亡率预测的准确性，因此将术前“加法EuroSCORE”（欧洲心脏手术风险评估系统）与术后“加法CASUS”（心脏外科手术评分）相结合）以形成“修改后的CASUS”。材料与方法我们将2007年1月至2010年12月期间接受心脏手术的所有连续成年患者纳入我们的前瞻性研究。我们的单中心研究是在德国综合转诊大学医院进行的。使用校准和辨别统计数据对原始添加剂和“改良的CASUS”进行了测试。我们通过DeLong的方法比较了接收器特征曲线（ROC）的曲线下面积（AUC），并计算了总体正确分类（OCC）值。结果5207例患者的平均年龄为67.2±10.9岁。虽然ICU死亡率为5.9％，但我们观察到平均ICU停留时间为4.6±7.0天。两种模型均具有出色的辨别力（“改良CASUS”的平均AUC：≥0.929;“ Additive CASUS”：≥0.920），根据DeLong的说法，无显着差异。两种模型均未在校准中显示出显着的p值（<0.05）。我们在第二天检测到最佳OCC（修改后：96.5％，原始：96.6％）。结论我们的“加法”和“修正” CASUS是合理的总体预测指标。通过结合术前和术后评分系统，我们无法检测到心脏手术死亡率预测准确性的任何改善。因此，建议对两个单独的元素进行单独计算。

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