经导管主动脉瓣置换术后死亡风险预测模型系统评价

目的 系统评价经导管主动脉瓣置换术后死亡风险预测模型.方法 在Cochrane Library、EMBASE、PubMed、Web of Science、中国生物医学文献数据库、中国知网、维普和万方数据库中检索经导管主动脉瓣置换术后死亡风险预测模型,检索时限为2000年1月1日—2021年2月1日.由两名研究者独立筛选...

Mortality Risk Prediction Models After Transcatheter Aortic Valve Replacement:A Systematic Review

Objective To systematically review the mortality risk prediction models after transcatheter aortic valve replacement.Methods We searched Cochrane Library、EMBASE、PubMed、Web of Science,CBM,CNKI,VIP and Wanfang Data from January 1,2000 to February 1,2021.Two researchers independently screened the literature,extracted information,and then used prediction model risk of bias assessment tool(PROBAST)to evaluate the quality of the models included in the literature.Results A total of 14 studies were included,of which 11 were prospective cohort studies and 3 were retrospective studies.12 models were internally or externally verified,while 3 models were not verified.The most common predictors in the included model followed by age,non-femoral approach,glomerular rate filtration,pulmonary hypertension,body mass index,NYHA function classⅣ,gender,left ventricular ejection fraction,hemodialysis,serum albumin,and lung disease.The area under the curve of the mortality risk prediction models for hospitalization,30 days,and one year after surgery were 0.66 to 0.74,0.59 to 0.76,and 0.60 to 0.83 respectively.In terms of results of bias,three studies had a low risk of bias,three studies had an unclear risk of bias,and 8 studies had a higher risk of bias.Bias mainly comes from the data analysis,including the processing of missing data and the selection of predictive variables.Conclusion The research on the prediction model of death risk after transcatheter aortic valve replacement is still in the development stage.In the future,a local prediction model with excellent performance and low risk of bias should be developed and internally or externally verified.