Journal of Chest Surgery

  • 제39권10호
  • /
  • Pages.749-753
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  • 2006
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  • 2765-1606(pISSN)
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  • 2765-1614(eISSN)
대한심장혈관흉부외과학회 (The Korean Society for Thoracic and Cardiovascular Surgery)
권호 표지

관상동맥 우회로술의 수술 위험인자에 대한 스코어 시스템

Score System for Operative Risk Evaluation in Coronary Artery Bypass Surgery

  • 강준규 (울산대학교 의과대학 서울아산병원 흉부외과) ;
  • 김종욱 (울산대학교 의과대학 강릉아산병원 흉부외과) ;
  • 신승수 (아주대학교의료원 흉부외과) ;
  • 정철현 (울산대학교 의과대학 서울아산병원 흉부외과) ;
  • 이재원 (울산대학교 의과대학 서울아산병원 흉부외과) ;
  • 송명근 (울산대학교 의과대학 서울아산병원 흉부외과) ;
  • 이정숙 (울산대학교 의과대학 서울아산병원 흉부외과) ;
  • 송현 (울산대학교 의과대학 서울아산병원 흉부외과)
  • Kang Joon-Kyu (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim Chong-Wook (Department of Thoracic and Cardiovascular Surgery, Gangneung Asan Medical Center, University of Ulsan College of Medicine) ;
  • Sheen Seung-Soo (Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine) ;
  • Chung Cheol-Hyun (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee Jae-Won (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Song Meong-Gun (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee Jung-Sook (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Song Hyun (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • 발행 : 2006.10.01
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초록

배경: 본 연구는 관상동맥 우회로술의 수술위험도를 예측할 수 있는 스코어 시스템을 만들고자 하였다. 대상 및 방법: 2000년 1월부터 2005년 9월까지 본원에서 시행되었던 관상동맥 우회로술 2,993예를 대상으로 여러 가지 수술 전후의 인자들에 대하여 후향적 연구를 진행하였다. 결과: 총 조기 수술사망률은 2.4%였으며 조기 사망에 통계적으로 의의 있게 연관된 것으로 나타난 7가지 인자(수술 전의 좌심실기능 부전(좌심실 구출률 30% 이하), 수술 전 신부전의 진단, 수술 전 1주일 이내 심근 경색, 재수술, 복합수술, 수술 전 심전도상에서의 심방 세동, 수술 전 대동맥 내 풍선 삽입술의 시행)의 베타지수(beta coefficient)를 지수화하여 스코어 시스템을 구하였다. 이 스코어 시스템에 대하여 ROC 커브와 Hosmer and Lemeshow goodness of fit test를 시행하여 적정성을 검증하였다. 결론: 본 시스템은 적정성 검사 결과 적정함을 나타냈지만 이후 더 많은 증례와 다른 병원과의 공조를 통하여 더 좋은 시스템의 확립이 중요하다.

Background: The purpose of this study is to assess a score system for operative risk evaluation of CABG. Material and Method: From January 2001 to September 2005, retrospective study for various perioperative factors of 2993 cases was done. Result: The early operative mortality was 2.4% and the beta coefficients of 7 core variables related to it (preoperative LV dysfuction, preoperative renal failure, MI within 1 week, reoperation, combined surgery, preoperative atrial fibrillation, preoperative IABP) were adjusted to score system. ROC curve and Hosmer and Lemeshow goodness of fit test was done. Conclusion: This score system was effective in assessing operative risk of CABG. But It is necessary to gather larger volume of case and perform multicenter study.

키워드

참고문헌

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