目的:为了比较灵敏度,特异性,接收机工作特性(ROC),和曲线下面积(AUC)值使用修正的脆弱指数11(mFI-11),EuroSCOREII,结合mFI-11和EuroSCOREII预测院内死亡率和复合发病率。
方法:回顾性队列研究单位:Songklanagarind医院,泰国南部的三级护理中心。
方法:在2017年1月至2022年12月期间接受了择期心脏直视手术的年龄≥60岁的老年患者。
方法:构建ROC曲线以评估EuroSCOREII和mFI-11预测院内死亡率和术后并发症的判别力。
结果:所有患者的实际住院死亡率为2.5%。mFI-11,EuroSCOREII,结合mFI-11和EuroSCOREII预测住院死亡率是好的,各自的AUC值为0.733(95%置信区间[CI],0.6157-0.8499),0.793(95%CI,0.6826-0.9026),和0.78(95%CI,0.6686-0.893)。mFI-11预测术后心脏的AUC,呼吸,神经学,肾脏并发症为0.558(95%CI,0.5101-0.6063),0.606(95%CI,0.5542-0.6581),0.543(95%CI,0.4533-0.6337),和0.652(95%CI,0.5859-0.7179),分别,EuroSCOREII的指数为0.553(95%CI,0.5038-0.6013),0.631(95%CI,0.578-0.6836),0.619(95%CI,0.5306-0.7076),和0.702(95%CI,0.6378-0.7657),分别。
结论:mFI-11和EuroSCOREII在ROC分析中表现出良好的区分度,EuroSCOREII对老年择期心脏手术患者的院内死亡率显示出较高的预测准确性。然而,在多元逻辑回归中,这两个评分都不能独立预测死亡率,它们的组合也没有显着增强预测能力。此外,两种评分在预测术后并发症方面效果较差.
OBJECTIVE: To compare sensitivity, specificity, receiver operating characteristic (ROC), and area under the curve (AUC) values using the modified Frailty Index 11 (mFI-11), EuroSCORE II, and combined mFI-11 and EuroSCORE II to predict in-hospital mortality and composite morbidities.
METHODS: Retrospective cohort study SETTING: Songklanagarind Hospital, a tertiary care center in southern Thailand.
METHODS: Elderly patients age ≥60 years who underwent elective open-heart surgical procedures on a pump between January 2017 and December 2022 were included.
METHODS: ROC curves were constructed to evaluate the discriminatory power of EuroSCORE II and mFI-11 for predicting in-hospital mortality and postoperative complications.
RESULTS: The actual in-hospital mortality was 2.5% for all patients. The discriminative accuracy of mFI-11, EuroSCORE II, and combined mFI-11 with EuroSCORE II for predicting in-hospital mortality was good, with respective AUC values of 0.733 (95% confidence interval [CI], 0.6157-0.8499), 0.793 (95% CI, 0.6826-0.9026), and 0.78 (95% CI, 0.6686-0.893). The AUC of mFI-11 for predicting postoperative cardiac, respiratory, neurologic, and renal complications was 0.558 (95% CI, 0.5101-0.6063), 0.606 (95% CI, 0.5542-0.6581), 0.543 (95% CI, 0.4533-0.6337), and 0.652 (95% CI, 0.5859-0.7179), respectively, and that of EuroSCORE II was 0.553 (95% CI, 0.5038-0.6013), 0.631 (95% CI, 0.578-0.6836), 0.619 (95% CI, 0.5306-0.7076), and 0.702 (95% CI, 0.6378-0.7657), respectively.
CONCLUSIONS: The mFI-11 and EuroSCORE II demonstrated good discrimination in ROC analysis, with EuroSCORE II showing superior predictive accuracy for in-hospital mortality in elderly elective cardiac surgery patients. However, neither score independently predicted mortality in multiple logistic regression, nor did combining them enhance predictive power significantly. Furthermore, both scores were less effective in predicting postoperative complications.