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EAARN评分对于心脏再同步治疗患者临床预后的预测价值

Prediction efficiency of EAARN score for clinical outcome in patients with cardiac resynchronization therapy

摘要:

目的 探讨EAARN评分系统对心脏再同步治疗(cardiac resynchronization therapy,CRT)患者全因死亡的预测价值.方法 回顾性选取2010年1月至2014年12月于阜外医院心律失常中心首次接受CRT的264例患者临床资料,行EAARN评分(E:左心室射血分数,A:年龄,A:房颤,R:肾功能,N:纽约心脏病学会心功能分级),随访终点为全因死亡.Kaplan-Meier法比较各组临床预后,采用受试者工作特征(receiver operating characteristic)曲线下面积(area under curve,AUC)评估EAARN评分系统对接受CRT患者全因死亡的预测价值,采用Hosmer-Lemeshow法评价拟合度.结果 共有33例患者在随访时间内死亡,定义0~1个低危组;2~3个中危组;3个以上高危组.其中低危组共199例,死亡22例;中危组共42例,死亡5例;高危组共23例,死亡6例.3组间患者死亡率差异无统计学意义(log-rank检验,P=0.316).EARRN评分系统预测1年内全因死亡的AUC为0.559.Hosmer-Lemeshow拟合度尚可(P=0.49).结论 EAARN评分系统对CRT患者预后的预测效能不佳.

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abstracts:

Objective To evaluate the role of EAARN score in risk-stratifying in patients with heart failure (HF) who underwent cardiac resynchronization therapy (CRT) and in predicting prognosis.Methods In this single-center retrospective cohort study,a total of 264 HF patients which had CRT implantation between January 2010 and December 2014 were enrolled.Primary outcomes were defined as all-cause mortality.Patients were divided into three groups according to EAARN score system:0-1 scores group (n =199),2-3 scores group (n =42) and >3 scores group (n =23).Kaplan-Meier analyses for each group and score were analyzed respectively.Discrimination and calibration of EAARN score system were evaluated through c-statistics and Hosmer-Lemeshow(H-L) goodness-of-fit test.Results A total of 33 patients died,22 of 199 patients died in 0-1 score group,5 of 42 died in 2-3 scores group,and 6 of 23 died in >3 scores group.There were no significantly difference among 3 groups (log-rank test,P=0.316).Discrimination of EAARN was inadequate for the outcome (AUC =0.559).EAARN was a good fit of dead for all-cause mortality (P =0.49).Conclusion The EAARN score system unsuccessfully stratifies HF patients with CRT.

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