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急性肠系膜梗死术前死亡预测模型:一项基于人群的研究。

Mortality Prediction Model before Surgery for Acute Mesenteric Infarction: A Population-Based Study.

作者信息

Lin Shang-Wei, Chen Chung-Yen, Su Yu-Chieh, Wu Kun-Ta, Yu Po-Chin, Yen Yung-Chieh, Chen Jian-Han

机构信息

Department of Surgery, E-Da Hospital, Kaohsiung 82445, Taiwan.

Healthcare Group Department of Medical Education, E-Da Hospital, Kaohsiung 82445, Taiwan.

出版信息

J Clin Med. 2022 Oct 8;11(19):5937. doi: 10.3390/jcm11195937.

Abstract

Surgery for acute mesenteric infarction (AMI) is associated with high mortality. This study aimed to generate a mortality prediction model to predict the 30-day mortality of surgery for AMI. We included patients ≥18 years who received bowel resection in treating AMI and randomly divided into the derivation and validation groups. After multivariable analysis, the ‘Surgery for acute mesenteric infarction mortality score’ (SAMIMS) system was generated and was including age >62-year-old (3 points), hemodialysis (2 points), congestive heart failure (1 point), peptic ulcer disease (1 point), diabetes (1 point), cerebrovascular disease (1 point), and severe liver disease (4 points). The 30-day-mortality rates in the derivation group were 4.4%, 13.4%, 24.5%, and 32.5% among very low (0 point), low (1−3 point(s)), intermediate (4−6 points), and high (7−13 points)-risk patients. Compared to the very-low-risk group, the low-risk (OR = 3.332), intermediate-risk (OR = 7.004), and high-risk groups (OR = 10.410, p < 0.001) exhibited higher odds of 30-day mortality. We identified similar results in the validation group. The areas under the ROC curve were 0.677 and 0.696 in the derivation and validation groups. Our prediction model, SAMIMS, allowed for the stratification of the patients’ 30-day-mortality risk of surgery for acute mesenteric infarction.

摘要

急性肠系膜梗死(AMI)手术的死亡率很高。本研究旨在建立一个死亡率预测模型,以预测AMI手术的30天死亡率。我们纳入了年龄≥18岁、因治疗AMI接受肠切除的患者,并将其随机分为推导组和验证组。经过多变量分析,生成了“急性肠系膜梗死手术死亡率评分”(SAMIMS)系统,该系统包括年龄>62岁(3分)、血液透析(2分)、充血性心力衰竭(1分)、消化性溃疡病(1分)、糖尿病(1分)、脑血管疾病(1分)和严重肝病(4分)。在推导组中,极低风险(0分)、低风险(1 - 3分)、中度风险(4 - 6分)和高风险(7 - 13分)患者的30天死亡率分别为4.4%、13.4%、24.5%和32.5%。与极低风险组相比,低风险组(OR = 3.332)、中度风险组(OR = 7.004)和高风险组(OR = 10.410,p < 0.001)的30天死亡几率更高。我们在验证组中也得到了类似的结果。推导组和验证组的ROC曲线下面积分别为0.677和0.696。我们的预测模型SAMIMS能够对急性肠系膜梗死手术患者的30天死亡风险进行分层。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2220/9571294/c34aa6b897b1/jcm-11-05937-g001.jpg

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