Three Scoring Systems For Postoperative PCI In Elderly Patients With Coronary Heart Disease Predictive Comparison Of Major Adverse Cardiovascular And Cerebrovascular Events In Hospital

Research objectivesTo evaluate the three scoring systems of the European Cardiac Surgery Risk Assessment System(Euro SCORE II),Logistic Euro SCORE,and NCDRCath PCI Risk Score System for percutaneous coronary intervention(PCI).The predictive value of major adverse cardiovascular and cerebrovascular events(MACCE)in patients after the PCI.Research methods The hospitalization data of 871 consecutive patients with PCI after continuous admission were retrospectively collected.Logistic Euro SCORE,Euro SCORE II and NCDRCath PCI were used to predict the incidence of MACCE in each patient and predict the average incidence of MACCE in the whole group.Patients were divided into low-risk group,intermediate-risk group and high-risk group according to each scoring system,and the predicted MACCE incidence rate and actual MACCE incidence rate of each group were compared.The predictive degree of the scoring system was evaluated using the Receiver Operating Characteristic(ROC)curve,and the predicted calibrated degree was measured by the Hosmer-Lemeshow(H-L)goodness-of-fit test,which was determined by the full group and group respectively.The calibration evaluation is used to compare the predicted performance of the three evaluation systems.Research results The postoperative in-hospital MACCE occurred in 33 patients(3.79%).The Euro SCORE II score predicted the average incidence of MACCE in the whole group was 2.33%,which was the closest to the true value;the Logistic Euro SCORE predicted value was 6.69%,and the NCDRCath PCI was 0.66%.The Euro SCORE II and Logistic Euro SCORE scores were better for predicting the occurrence of MACCE in the whole group(H-L: p>0.05),and the NCDRCath PCI score was poorly predictive for the occurrence of MACCE in the whole group(H-L: p<0.05).The Euro SCORE II,Logistic Euro SCORE,and NCDRCath PCI scores predict the area under the ROC curve for PCICE in elderly patients after PCI,which are 0.848,0.781,and 0.789,respectively.Therefore,the Euro SCORE II score is better for the entire group,and the Logistic Euro SCORE and NCDRCath PCI scores are for the whole group.The degree of discrimination of the patient is general.In predicting the incidence of MACCE in grouped patients,Euro SCORE II predicted that the incidence of MACCE in the low-risk group was closer to the true value,but underestimated the incidence of MACCE in the high-risk group;the Logistic Euro SCORE score predicted the incidence of MACCE in the intermediate-risk group more realistic.Value,but overestimated the incidence of MACCE in high-risk patients;NCDRCath PCI score underestimated the incidence of MACCE in group patients.The three groups of scores had better predictive calibration for grouped patients with MACCE(H-L: p>0.05).The Euro SCORE II and NCDRCath PCI scores showed poor prognosis for predicting MACCE in patients with low-risk risk,and the area under the ROC curve was less than 0.7.The Euro SCORE II and NCDRCath PCI scores were generally predictive of MACCE occurrence in high-risk groups(AUC=0.792,0.712).The Logistic Euro SCORE score was poor in predicting the rate of MACCE in patients with low-risk group(AUC=0.597<0.70).The Logistic Euro SCORE score showed a general ability to predict the incidence of MACCE in the middle-risk group and the high-risk group(AUC=0.741,0.743).Research conclusions1.The incidence of in-hospital MACCE in elderly patients with coronary heart disease after PCI was 3.79%.2.The Euro SCORE II and Logistic Euro SCORE scores have a good predictive and predictive effect on the occurrence of postoperative MACCE in the whole group,and the Euro SCORE II score predicts better discrimination.The NCDRCath PCI score predicts a lower clinical value of postoperative in-hospital MACCE in the entire group.3.Among the grouped patients,the Euro SCORE II score and Logistic Euro SCORE have an advantage in predicting MACCE in the low-risk group.However,Euro SCORE II may not be suitable for the identification of very high-risk patients.If risk assessment scores are used to better predict the incidence of MACCE after PCI in elderly patients,further improvement is needed.