[非心脏手术患者的术前风险预测模型 :正确理解和使用风险评分]。

René M'Pembele, Sebastian Roth, Giovanna Lurati Buse
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引用次数: 0

摘要

风险预测模型是术前评估的既定组成部分。欧洲心脏病学会在其指南中提出了几种风险评分,但临床医生大多不清楚这些评分的益处。本文介绍了准备有效预测模型的各个步骤,重点是参数、判别、校准和外部验证。研究了指南中建议的风险评分在这些参数方面的临床益处。在验证队列中,所有建议的风险评分似乎都显示出良好的区分度。只有少数可靠数据可用于良好的校准。各个模型的外部有效性尚不明确。由于缺乏外部队列的校准或区分数据,因此无法推荐风险评分的普遍益处。无法对风险进行精确估算。
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[Preoperative risk prediction models for noncardiac surgery patients : Interpret and use risk scores correctly].

Risk prediction models are an established component of the preoperative evaluation. In its guidelines the European Society for Cardiology proposes several risk scores but the benefit of these is mostly unclear for clinicians. This article describes the individual steps in the preparation of a valid prediction model with a focus on the parameters, discrimination, calibration and external validation. The clinical benefits of the risk scores proposed in the guidelines with respect to these parameters was investigated. All proposed risk scores appear to show a good discrimination in the validation cohorts. Only a few reliable data for a good calibration could be compiled. The external validity of the individual models is unclear. The general benefit of the risk scores cannot be recommended as data for calibration or discrimination in external cohorts are lacking. A precise estimation of the risk cannot be expected.

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