在初级保健人群中验证 IberScore 模型

Carlos Fernández-Labandera Ramos , Irene Moral , Carlos Brotons , Luis Quevedo Aguado , Inmaculada Coca Prieto , Pedro Valdivielso , Miguel Ángel Sánchez Chaparro
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引用次数: 0

摘要

背景这项研究的目的是在初级医疗机构的就诊人群中验证IberScore心血管风险模型。方法选取2008年和/或2009年期间在初级医疗中心就诊并随访至2018年的无心血管病史患者作为队列对象,使用IberScore公式计算队列中所有受试者的心血管风险,并校准模型,以风险十分位数表示随访10年期间的预期事件比例和观察到的事件比例,按性别进行分层。研究共纳入了 10,085 名在 2008 年和/或 2009 年就诊的患者。根据 IberScore,男性发生致命或非致命心血管事件的 10 年平均风险为 17.07%(标准差为 20.13),平均估计血管年龄比生理年龄高出 4 岁以上;而女性发生致命或非致命心血管事件的 10 年平均风险为 7.91%(标准差为 9.03),平均估计血管年龄比生理年龄高出 4 岁以上。ROC曲线下面积显示,该模型对男性的识别指数为 0.86 (95% CI 0.84-0.88),对女性的识别指数为 0.82 (95% CI 0.79-0.85)。
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Validation of the IberScore model in a primary care population

Background

This study aimed to validate the IberScore cardiovascular risk model in a population attended in the primary care setting.

Methods

A cohort of patients with no history of cardiovascular disease visited in a primary care center during the years 2008 and/or 2009 and followed up until 2018 was selected.

Cardiovascular risk was calculated with the IberScore formula for all the subjects of the cohort and the model was calibrated, graphically represented by risk deciles the proportion of expected events and proportion of observed events at 10-year follow-up, stratified by sex. The area under the ROC curve was calculated to assess the discrimination of the model.

Results

A total of 10,085 patients visited during the years 2008 and/or 2009 were included in the study. Men showed a mean 10-year risk of suffering a fatal or non-fatal cardiovascular events according to IberScore of 17.07% (SD 20.13), with a mean estimated vascular age of more than 4 years higher than the biological age; while women had a mean 10-year risk of 7.91% (SD 9.03), with an estimated vascular age of more than 2 years above the biological age.

The area under the ROC curve showed a discrimination index of the model of 0.86 (95% CI 0.84–0.88) in men and 0.82 (95% CI 0.79–0.85) in women.

Conclusion

IberScore model discriminates well in the population attended in primary care but the model overestimates the risk.

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