南方医科大学学报 ›› 2026, Vol. 46 ›› Issue (6): 1301-1312.doi: 10.12122/j.issn.1673-4254.2026.06.10
• • 上一篇
王沛齐1(
), 张凯1(
), 王海军2, 杨路加1, 刘艳红1, 曹江北1, 李皓1, 米卫东1(
), 娄景盛1(
)
收稿日期:2025-11-29
出版日期:2026-06-20
发布日期:2026-06-24
通讯作者:
米卫东,娄景盛
E-mail:qiqi218@sina.com;zhangkai971205@163.com;wwdd1962@163.com;loujingsheng@163.com
作者简介:王沛齐,主治医师,博士,E-mail: qiqi218@sina.com基金资助:
Peiqi WANG1(
), Kai ZHANG1(
), Haijun WANG2, Lujia YANG1, Yanhong LIU1, Jiangbei CAO1, Hao LI1, Weidong MI1(
), Jingsheng LOU1(
)
Received:2025-11-29
Online:2026-06-20
Published:2026-06-24
Contact:
Weidong MI, Jingsheng LOU
E-mail:qiqi218@sina.com;zhangkai971205@163.com;wwdd1962@163.com;loujingsheng@163.com
Supported by:摘要:
目的 探讨术前心内科会诊是否可以降低非心脏手术患者主要不良心脏事件(MACE)的发生率。 方法 研究共纳入7019例65岁及以上非心脏手术患者,患者均存在心电图(ECG)异常。主要结局指标为术后30 d内MACE的发生率。按7∶3比例将人群分为开发队列和验证队列,并根据ECG异常风险分为高危组和低危组。各亚组建立了MACE预测模型,采用受试者工作特征曲线(ROC曲线)分析其预测效能,并通过决策曲线分析(DCA)评估术前心内科会诊的价值。 结果 开发队列共有4914例患者,3010例为低风险的异常心电图,其中61例发生MACE(2.0%),1904例为高风险的异常心电图,其中59例发生MACE(3.1%)。在MACE的预测模型中,低风险组包含6个危险因素(AUC=0.772),而高风险组包含5个危险因素(AUC=0.769)。对于低风险的异常心电图患者,接受心内科会诊并未显示出显著的益处(预测发生主要不良心脏事件的风险阈值为0.02)。高风险异常心电图组和合并某些危险因素的低风险异常心电图组中,接受心内科会诊显示出显著的获益(预测发生主要不良心脏事件的风险阈值分别为0.3和0.229)。 结论 高危异常ECG和有特定危险因素的低危异常ECG患者行心内科会诊可降低术后MACE发生率;而单纯低危异常ECG患者术前心内科会诊并未见明显获益,且未改善MACE的发生率。
王沛齐, 张凯, 王海军, 杨路加, 刘艳红, 曹江北, 李皓, 米卫东, 娄景盛. 术前心内科会诊对非心脏手术患者主要不良心脏事件的影响:一项回顾性队列研究[J]. 南方医科大学学报, 2026, 46(6): 1301-1312.
Peiqi WANG, Kai ZHANG, Haijun WANG, Lujia YANG, Yanhong LIU, Jiangbei CAO, Hao LI, Weidong MI, Jingsheng LOU. Impact of preoperative cardiology consultation on major adverse cardiac events in non-cardiac surgery patients: a retrospective cohort study[J]. Journal of Southern Medical University, 2026, 46(6): 1301-1312.
| Classification | Contents |
|---|---|
| Low-risk abnormal ECG | Sinus bradycardia (≥50 beats per minute ) Sinus tachycardia (≤120 beats per minute ) Sinus rhythm with occasional atrial premature beats Sinus rhythm with occasional premature ventricular contractions Sinus rhythm with first-degree atrioventricular block Sinus rhythm with incomplete right bundle branch block Sinus rhythm with localized right bundle branch block Sinus rhythm with complete right bundle branch block Sinus rhythm with left anterior fascicular block Sinus rhythm with left axis deviation Sinus rhythm with right axis deviation Sinus rhythm with low voltage in limb leads Sinus rhythm with early repolarization Sinus rhythm with normal P wave morphology Sinus rhythm with widened P wave morphology Sinus rhythm with abnormal T Sinus irregularity |
| High-risk abnormal ECG | Sinus bradycardia (≤49 beats per minute ) Sinus tachycardia(≥121 beats per minute ) Sinus rhythm with left ventricular hypertrophy Sinus rhythm with prolonged QTc interval Sinus rhythm with second-degree atrioventricular block Sinus rhythm with third-degree atrioventricular block Sinus rhythm with complete left bundle branch block Sinus rhythm with frequent premature atrial contractions Sinus rhythm with frequent atrial premature beats Sinus rhythm with atrial premature beats in a 2:1 pattern Sinus rhythm with elevated u-wave Sinus rhythm with abnormal Q-waves Sinus rhythm with inverted T waves in leads V4-V6 Sinus rhythm with high voltage T wave Sinus rhythm with ST-T depression Sinus rhythm with ST-T segment elevation Supraventricular tachycardia Ventricular tachycardia Paced rhythm Short pr syndrome Atrial fibrillation Atrial flutter Accelerated A-V junctional escape rhythm Brugada syndrome Pre-excitation syndrome Combination of two low-risk abnormal electrocardiographic findings Combination of two or more high-risk abnormal electrocardiographic findings |
表1 异常心电图分类
Tab.1 Classification of abnormal ECG
| Classification | Contents |
|---|---|
| Low-risk abnormal ECG | Sinus bradycardia (≥50 beats per minute ) Sinus tachycardia (≤120 beats per minute ) Sinus rhythm with occasional atrial premature beats Sinus rhythm with occasional premature ventricular contractions Sinus rhythm with first-degree atrioventricular block Sinus rhythm with incomplete right bundle branch block Sinus rhythm with localized right bundle branch block Sinus rhythm with complete right bundle branch block Sinus rhythm with left anterior fascicular block Sinus rhythm with left axis deviation Sinus rhythm with right axis deviation Sinus rhythm with low voltage in limb leads Sinus rhythm with early repolarization Sinus rhythm with normal P wave morphology Sinus rhythm with widened P wave morphology Sinus rhythm with abnormal T Sinus irregularity |
| High-risk abnormal ECG | Sinus bradycardia (≤49 beats per minute ) Sinus tachycardia(≥121 beats per minute ) Sinus rhythm with left ventricular hypertrophy Sinus rhythm with prolonged QTc interval Sinus rhythm with second-degree atrioventricular block Sinus rhythm with third-degree atrioventricular block Sinus rhythm with complete left bundle branch block Sinus rhythm with frequent premature atrial contractions Sinus rhythm with frequent atrial premature beats Sinus rhythm with atrial premature beats in a 2:1 pattern Sinus rhythm with elevated u-wave Sinus rhythm with abnormal Q-waves Sinus rhythm with inverted T waves in leads V4-V6 Sinus rhythm with high voltage T wave Sinus rhythm with ST-T depression Sinus rhythm with ST-T segment elevation Supraventricular tachycardia Ventricular tachycardia Paced rhythm Short pr syndrome Atrial fibrillation Atrial flutter Accelerated A-V junctional escape rhythm Brugada syndrome Pre-excitation syndrome Combination of two low-risk abnormal electrocardiographic findings Combination of two or more high-risk abnormal electrocardiographic findings |
| Characteristic | MACE No. (%) (n=7019) | |
|---|---|---|
| Negative (n=6848) | Positive (n=171) | |
| Cardiology consultation | ||
| No | 2132 (31.1%) | 6 (3.5%) |
| Yes | 4716 (68.9%) | 165 (96.5%) |
| Gender | ||
| Female | 3038 (44.4%) | 81 (47.4%) |
| Male | 3810 (55.6%) | 90 (52.6%) |
| Age (year) | ||
| <75 | 5555 (81.1%) | 111 (64.9%) |
| ≥75 | 1293 (18.9%) | 60 (35.1%) |
| BMI (kg/m2) | ||
| 18-24 | 2898 (42.3%) | 71 (41.5%) |
| <18 | 173 (2.5%) | 4 (2.3%) |
| >24 | 3777 (55.2%) | 96 (56.1%) |
| Comorbidities | ||
| Hypertension | 3390 (49.5%) | 105 (61.4%) |
| Cerebrovascular disease | 547 (8%) | 19 (11.1%) |
| Diabetes | 1768 (25.8%) | 44 (25.7%) |
| Coronary artery disease | 965 (14.1%) | 48 (28.1%) |
| Arrhythmia | 1174 (17.1%) | 51 (29.8%) |
| Valvular heart disease | 39 (0.6%) | 3 (1.8%) |
| Myocardial infarction | 105 (1.5%) | 12 (7%) |
| Congestive heart failure | 18 (0.3%) | 11 (6.4%) |
| Hepatic insufficiency | 363 (5.3%) | 8 (4.7%) |
| Renal insufficiency | 96 (1.4%) | 8 (4.7%) |
| RBC (1012/L) | ||
| 3.5-5.5 | 6290 (91.9%) | 136 (79.5%) |
| >5.5 | 68 (1%) | 1 (0.6%) |
| <3.5 | 490 (7.2%) | 34 (19.9%) |
| PLT (109/L) | ||
| 100-300 | 6008 (87.7%) | 144 (84.2%) |
| <100 | 157 (2.3%) | 0 (0%) |
| >300 | 683 (10%) | 27 (15.8%) |
| HGB (g/L) | ||
| 110-160 | 5906 (86.2%) | 124 (72.5%) |
| >160 | 184 (2.7%) | 6 (3.5%) |
| <110 | 758 (11.1%) | 41 (24%) |
| WBC (109/L) | ||
| 4-10 | 6004 (87.7%) | 147 (86%) |
| <4 | 588 (8.6%) | 8 (4.7%) |
| >10 | 256 (3.7%) | 16 (9.4%) |
| Cr (µmmol/L) | ||
| 44-110 | 6419 (93.7%) | 144 (84.2%) |
| <44 | 116 (1.7%) | 5 (2.9%) |
| >110 | 313 (4.6%) | 22 (12.9%) |
| GLU (mmol/L) | ||
| 3.4-6.1 | 5350 (78.1%) | 126 (73.7%) |
| <3.4 | 32 (0.5%) | 0 (0%) |
| >6.1 | 1466 (21.4%) | 45 (26.3%) |
| APTT (s) | ||
| ≤40 | 5846 (85.4%) | 136 (79.5%) |
| >40 | 1002 (14.6%) | 35 (20.5%) |
| D-dimer (ng/mL) | ||
| ≤0.5 | 4756 (69.5%) | 53 (31%) |
| >0.5 | 2092 (30.5%) | 118 (69%) |
| Abnormal ECG | ||
| Low-risk abnormal ECG | 4216 (61.6%) | 86 (50.3%) |
| High-risk abnormal ECG | 2632 (38.4%) | 85 (49.7%) |
| Type of surgery | ||
| ENT, ophthalamic, oral surgery and minor surgery | 1045 (15.3%) | 11 (6.4%) |
| Hepatobiliary pancreatic splenic surgery | 1390 (20.3%) | 22 (12.9%) |
| Orthopedic surgery | 681 (9.9%) | 13 (7.6%) |
| Pelvic surgery | 885 (12.9%) | 22 (12.9%) |
| Nervous system surgery | 994 (14.5%) | 25 (14.6%) |
| Gastrointestinal surgery | 1116 (16.3%) | 45 (26.3%) |
| Thoracic and vascular surgery | 737 (10.8%) | 33 (19.3%) |
表2 患者基线人口学和临床特征
Tab.2 Baseline demographic and clinical characteristics of the patients with and without MACE
| Characteristic | MACE No. (%) (n=7019) | |
|---|---|---|
| Negative (n=6848) | Positive (n=171) | |
| Cardiology consultation | ||
| No | 2132 (31.1%) | 6 (3.5%) |
| Yes | 4716 (68.9%) | 165 (96.5%) |
| Gender | ||
| Female | 3038 (44.4%) | 81 (47.4%) |
| Male | 3810 (55.6%) | 90 (52.6%) |
| Age (year) | ||
| <75 | 5555 (81.1%) | 111 (64.9%) |
| ≥75 | 1293 (18.9%) | 60 (35.1%) |
| BMI (kg/m2) | ||
| 18-24 | 2898 (42.3%) | 71 (41.5%) |
| <18 | 173 (2.5%) | 4 (2.3%) |
| >24 | 3777 (55.2%) | 96 (56.1%) |
| Comorbidities | ||
| Hypertension | 3390 (49.5%) | 105 (61.4%) |
| Cerebrovascular disease | 547 (8%) | 19 (11.1%) |
| Diabetes | 1768 (25.8%) | 44 (25.7%) |
| Coronary artery disease | 965 (14.1%) | 48 (28.1%) |
| Arrhythmia | 1174 (17.1%) | 51 (29.8%) |
| Valvular heart disease | 39 (0.6%) | 3 (1.8%) |
| Myocardial infarction | 105 (1.5%) | 12 (7%) |
| Congestive heart failure | 18 (0.3%) | 11 (6.4%) |
| Hepatic insufficiency | 363 (5.3%) | 8 (4.7%) |
| Renal insufficiency | 96 (1.4%) | 8 (4.7%) |
| RBC (1012/L) | ||
| 3.5-5.5 | 6290 (91.9%) | 136 (79.5%) |
| >5.5 | 68 (1%) | 1 (0.6%) |
| <3.5 | 490 (7.2%) | 34 (19.9%) |
| PLT (109/L) | ||
| 100-300 | 6008 (87.7%) | 144 (84.2%) |
| <100 | 157 (2.3%) | 0 (0%) |
| >300 | 683 (10%) | 27 (15.8%) |
| HGB (g/L) | ||
| 110-160 | 5906 (86.2%) | 124 (72.5%) |
| >160 | 184 (2.7%) | 6 (3.5%) |
| <110 | 758 (11.1%) | 41 (24%) |
| WBC (109/L) | ||
| 4-10 | 6004 (87.7%) | 147 (86%) |
| <4 | 588 (8.6%) | 8 (4.7%) |
| >10 | 256 (3.7%) | 16 (9.4%) |
| Cr (µmmol/L) | ||
| 44-110 | 6419 (93.7%) | 144 (84.2%) |
| <44 | 116 (1.7%) | 5 (2.9%) |
| >110 | 313 (4.6%) | 22 (12.9%) |
| GLU (mmol/L) | ||
| 3.4-6.1 | 5350 (78.1%) | 126 (73.7%) |
| <3.4 | 32 (0.5%) | 0 (0%) |
| >6.1 | 1466 (21.4%) | 45 (26.3%) |
| APTT (s) | ||
| ≤40 | 5846 (85.4%) | 136 (79.5%) |
| >40 | 1002 (14.6%) | 35 (20.5%) |
| D-dimer (ng/mL) | ||
| ≤0.5 | 4756 (69.5%) | 53 (31%) |
| >0.5 | 2092 (30.5%) | 118 (69%) |
| Abnormal ECG | ||
| Low-risk abnormal ECG | 4216 (61.6%) | 86 (50.3%) |
| High-risk abnormal ECG | 2632 (38.4%) | 85 (49.7%) |
| Type of surgery | ||
| ENT, ophthalamic, oral surgery and minor surgery | 1045 (15.3%) | 11 (6.4%) |
| Hepatobiliary pancreatic splenic surgery | 1390 (20.3%) | 22 (12.9%) |
| Orthopedic surgery | 681 (9.9%) | 13 (7.6%) |
| Pelvic surgery | 885 (12.9%) | 22 (12.9%) |
| Nervous system surgery | 994 (14.5%) | 25 (14.6%) |
| Gastrointestinal surgery | 1116 (16.3%) | 45 (26.3%) |
| Thoracic and vascular surgery | 737 (10.8%) | 33 (19.3%) |
| Characteristic | MACE No. (%) (n=4914) | |
|---|---|---|
| Negative (n=4794) | Positive (n=120) | |
| Gender | ||
| Female | 2135 (44.5%) | 55 (45.8%) |
| Male | 2659 (55.5%) | 65 (54.2%) |
| Age (year) | ||
| <75 | 3858 (80.5%) | 80 (66.7%) |
| ≥75 | 936 (19.5%) | 40 (33.3%) |
| BMI (kg/m2) | ||
| 18-24 | 2019 (42.1%) | 45 (37.5%) |
| <18 | 132 (2.8%) | 3 (2.5%) |
| >24 | 2643 (55.1%) | 72 (60%) |
| Comorbidities | ||
| Hypertension | 2417 (50.4%) | 72 (60%) |
| Cerebrovascular disease | 388 (8.1%) | 11 (9.2%) |
| Diabetes | 1219 (25.4%) | 32 (26.7%) |
| Coronary artery disease | 689 (14.4%) | 34 (28.3%) |
| Arrhythmia | 814 (17%) | 36 (30%) |
| Valvular heart disease | 26 (0.5%) | 3 (2.5%) |
| Myocardial infarction | 78 (1.6%) | 6 (5%) |
| Congestive heart failure | 10 (0.2%) | 4 (3.3%) |
| Hepatic insufficiency | 263 (5.5%) | 7 (5.8%) |
| Renal insufficiency | 66 (1.4%) | 5 (4.2%) |
| RBC (1012/L) | ||
| 3.5-5.5 | 4402 (91.8%) | 97 (80.8%) |
| >5.5 | 48 (1%) | 1 (0.8%) |
| <3.5 | 344 (7.2%) | 22 (18.3%) |
| PLT (109/L) | ||
| 100-300 | 4188 (87.4%) | 103 (85.8%) |
| <100 | 114 (2.4%) | 0 (0%) |
| >300 | 492 (10.3%) | 17 (14.2%) |
| HGB (g/L) | ||
| 110-160 | 4131 (86.2%) | 90 (75%) |
| >160 | 134 (2.8%) | 5 (4.2%) |
| <110 | 529 (11%) | 25 (20.8%) |
| WBC (109/L) | ||
| 4-10 | 4196 (87.5%) | 100 (83.3%) |
| <4 | 417 (8.7%) | 6 (5%) |
| >10 | 181 (3.8%) | 14 (11.7%) |
| Cr (µmmol/L) | ||
| 44-110 | 4506 (94%) | 101 (84.2%) |
| <44 | 70 (1.5%) | 4 (3.3%) |
| >110 | 218 (4.5%) | 15 (12.5%) |
| GLU (mmol/L) | ||
| 3.4-6.1 | 3760 (78.4%) | 85 (70.8%) |
| <3.4 | 26 (0.5%) | 0 (0%) |
| >6.1 | 1008 (21%) | 35 (29.2%) |
| APTT (s) | ||
| ≤40 | 4111 (85.8%) | 100 (83.3%) |
| >40 | 683 (14.2%) | 20 (16.7%) |
| D-dimer (ng/mL) | ||
| ≤0.5 | 3330 (69.5%) | 38 (31.7%) |
| >0.5 | 1464 (30.5%) | 82 (68.3%) |
| Abnormal ECG | ||
| Low-risk abnormal ECG | 2949 (61.5%) | 61 (50.8%) |
| High-risk abnormal ECG | 1845 (38.5%) | 59 (49.2%) |
| Type of surgery | ||
| ENT, ophthalamic, oral surgery and minor surgery | 732 (15.3%) | 9 (7.5%) |
| Hepatobiliary pancreatic splenic surgery | 967 (20.2%) | 19 (15.8%) |
| Orthopedic surgery | 474 (9.9%) | 11 (9.2%) |
| Pelvic surgery | 618 (12.9%) | 15 (12.5%) |
| Nervous system surgery | 697 (14.5%) | 14 (11.7%) |
| Gastrointestinal surgery | 764 (15.9%) | 30 (25%) |
| Thoracic and vascular surgery | 542 (11.3%) | 22 (18.3%) |
表3 开发队列的基线人口学和临床特征
Tab.3 Baseline demographic and clinical characteristics of the patients in the model development cohort
| Characteristic | MACE No. (%) (n=4914) | |
|---|---|---|
| Negative (n=4794) | Positive (n=120) | |
| Gender | ||
| Female | 2135 (44.5%) | 55 (45.8%) |
| Male | 2659 (55.5%) | 65 (54.2%) |
| Age (year) | ||
| <75 | 3858 (80.5%) | 80 (66.7%) |
| ≥75 | 936 (19.5%) | 40 (33.3%) |
| BMI (kg/m2) | ||
| 18-24 | 2019 (42.1%) | 45 (37.5%) |
| <18 | 132 (2.8%) | 3 (2.5%) |
| >24 | 2643 (55.1%) | 72 (60%) |
| Comorbidities | ||
| Hypertension | 2417 (50.4%) | 72 (60%) |
| Cerebrovascular disease | 388 (8.1%) | 11 (9.2%) |
| Diabetes | 1219 (25.4%) | 32 (26.7%) |
| Coronary artery disease | 689 (14.4%) | 34 (28.3%) |
| Arrhythmia | 814 (17%) | 36 (30%) |
| Valvular heart disease | 26 (0.5%) | 3 (2.5%) |
| Myocardial infarction | 78 (1.6%) | 6 (5%) |
| Congestive heart failure | 10 (0.2%) | 4 (3.3%) |
| Hepatic insufficiency | 263 (5.5%) | 7 (5.8%) |
| Renal insufficiency | 66 (1.4%) | 5 (4.2%) |
| RBC (1012/L) | ||
| 3.5-5.5 | 4402 (91.8%) | 97 (80.8%) |
| >5.5 | 48 (1%) | 1 (0.8%) |
| <3.5 | 344 (7.2%) | 22 (18.3%) |
| PLT (109/L) | ||
| 100-300 | 4188 (87.4%) | 103 (85.8%) |
| <100 | 114 (2.4%) | 0 (0%) |
| >300 | 492 (10.3%) | 17 (14.2%) |
| HGB (g/L) | ||
| 110-160 | 4131 (86.2%) | 90 (75%) |
| >160 | 134 (2.8%) | 5 (4.2%) |
| <110 | 529 (11%) | 25 (20.8%) |
| WBC (109/L) | ||
| 4-10 | 4196 (87.5%) | 100 (83.3%) |
| <4 | 417 (8.7%) | 6 (5%) |
| >10 | 181 (3.8%) | 14 (11.7%) |
| Cr (µmmol/L) | ||
| 44-110 | 4506 (94%) | 101 (84.2%) |
| <44 | 70 (1.5%) | 4 (3.3%) |
| >110 | 218 (4.5%) | 15 (12.5%) |
| GLU (mmol/L) | ||
| 3.4-6.1 | 3760 (78.4%) | 85 (70.8%) |
| <3.4 | 26 (0.5%) | 0 (0%) |
| >6.1 | 1008 (21%) | 35 (29.2%) |
| APTT (s) | ||
| ≤40 | 4111 (85.8%) | 100 (83.3%) |
| >40 | 683 (14.2%) | 20 (16.7%) |
| D-dimer (ng/mL) | ||
| ≤0.5 | 3330 (69.5%) | 38 (31.7%) |
| >0.5 | 1464 (30.5%) | 82 (68.3%) |
| Abnormal ECG | ||
| Low-risk abnormal ECG | 2949 (61.5%) | 61 (50.8%) |
| High-risk abnormal ECG | 1845 (38.5%) | 59 (49.2%) |
| Type of surgery | ||
| ENT, ophthalamic, oral surgery and minor surgery | 732 (15.3%) | 9 (7.5%) |
| Hepatobiliary pancreatic splenic surgery | 967 (20.2%) | 19 (15.8%) |
| Orthopedic surgery | 474 (9.9%) | 11 (9.2%) |
| Pelvic surgery | 618 (12.9%) | 15 (12.5%) |
| Nervous system surgery | 697 (14.5%) | 14 (11.7%) |
| Gastrointestinal surgery | 764 (15.9%) | 30 (25%) |
| Thoracic and vascular surgery | 542 (11.3%) | 22 (18.3%) |
| Characteristic | MACE No. (%) (n=3010) | OR (univariable) | OR (multivariable) | |
|---|---|---|---|---|
| Negative (n=2949) | Positive (n=61) | |||
| Gender | ||||
| Female | 1281 (43.4%) | 22 (36.1%) | 1 [Reference] | - |
| Male | 1668 (56.6%) | 39 (63.9%) | 1.36 (0.80-2.31, P=0.252) | - |
| Age (year) | ||||
| <75 | 2404 (81.5%) | 42 (68.9%) | 1 [Reference] | 1 [Reference] |
| ≥75 | 545 (18.5%) | 19 (31.1%) | 2.00 (1.15-3.46, P=0.014) | 1.52 (0.83-2.77, P=0.174) |
| BMI (kg/m2) | ||||
| 18-24 | 1240 (42%) | 27 (44.3%) | 1 [Reference] | - |
| <18 | 82 (2.8%) | 2 (3.3%) | 1.12 (0.26-4.79, P=0.878) | - |
| >24 | 1627 (55.2%) | 32 (52.5%) | 0.90 (0.54-1.52, P=0.700) | - |
| Medical condition | ||||
| Hypertension | 1399 (47.4%) | 35 (57.4%) | 1.49 (0.89-2.49, P=0.126) | - |
| Cerebrovascular disease | 218 (7.4%) | 6 (9.8%) | 1.37 (0.58-3.21, P=0.473) | - |
| Diabetes | 730 (24.8%) | 13 (21.3%) | 0.82 (0.44-1.53, P=0.538) | - |
| Coronary artery disease | 346 (11.7%) | 19 (31.1%) | 3.40 (1.96-5.92, P<0.001) | 2.74 (1.46-5.14, P=0.002) |
| Arrhythmia | 425 (14.4%) | 11 (18%) | 1.31 (0.67-2.53, P=0.428) | - |
| Valvular heart disease | 11 (0.4%) | 1 (1.6%) | 4.45 (0.57-35.03, P=0.156) | - |
| Myocardial infarction | 28 (0.9%) | 4 (6.6%) | 7.32 (2.49-21.56, P<0.001) | 1.45 (0.39-5.41, P=0.584) |
| Congestive heart failure | 3 (0.1%) | 2 (3.3%) | 33.29 (5.46-202.93, P<0.001) | 32.50 (4.44-237.91, P<0.001) |
| Hepatic insufficiency | 165 (5.6%) | 3 (4.9%) | 0.87 (0.27-2.81, P=0.820) | - |
| Renal insufficiency | 43 (1.5%) | 1 (1.6%) | 1.13 (0.15-8.31, P=0.907) | - |
| RBC (1012/L) | ||||
| 3.5-5.5 | 2722 (92.3%) | 47 (77%) | 1 [Reference] | 1 [Reference] |
| >5.5 | 30 (1%) | 0 (0%) | 0.00 (0.00-Inf, P=0.985) | 0.00 (0.00-Inf, P=0.982) |
| <3.5 | 197 (6.7%) | 14 (23%) | 4.12 (2.23-7.61, P<0.001) | 2.49 (0.95-6.50, P=0.062) |
| PLT (109/L) | ||||
| 100-300 | 2604 (88.3%) | 52 (85.2%) | 1 [Reference] | - |
| <100 | 69 (2.3%) | 0 (0%) | 0.00 (0.00-Inf, P=0.977) | - |
| >300 | 276 (9.4%) | 9 (14.8%) | 1.63 (0.80-3.35, P=0.181) | - |
| HGB (g/L) | ||||
| 110-160 | 2555 (86.6%) | 42 (68.9%) | 1 [Reference] | 1 [Reference] |
| >160 | 80 (2.7%) | 4 (6.6%) | 3.04 (1.06-8.69, P=0.038) | 4.83 (1.55-15.07, P=0.007) |
| <110 | 314 (10.6%) | 15 (24.6%) | 2.91 (1.59-5.30, P<0.001) | 0.86 (0.34-2.15, P=0.750) |
| WBC (109/L) | ||||
| 4-10 | 2582 (87.6%) | 47 (77%) | 1 [Reference] | 1 [Reference] |
| <4 | 262 (8.9%) | 4 (6.6%) | 0.84 (0.30-2.35, P=0.738) | 0.97 (0.33-2.83, P=0.951) |
| >10 | 105 (3.6%) | 10 (16.4%) | 5.23 (2.57-10.64, P<0.001) | 3.88 (1.79-8.41, P<0.001) |
| Cr (µmmol/L) | ||||
| 44-110 | 2781 (94.3%) | 48 (78.7%) | 1 [Reference] | 1 [Reference] |
| <44 | 40 (1.4%) | 2 (3.3%) | 2.90 (0.68-12.33, P=0.150) | 1.65 (0.31-8.73, P=0.556) |
| >110 | 128 (4.3%) | 11 (18%) | 4.98 (2.53-9.82, P<0.001) | 3.63 (1.73-7.62, P<0.001) |
| GLU (mmol/L) | ||||
| 3.4-6.1 | 2340 (79.3%) | 47 (77%) | 1 [Reference] | - |
| <3.4 | 13 (0.4%) | 0 (0%) | 0.00 (0.00-Inf, P=0.985) | - |
| >6.1 | 596 (20.2%) | 14 (23%) | 1.17 (0.64-2.14, P=0.611) | - |
| APTT (s) | ||||
| ≤40 | 2541 (86.2%) | 51 (83.6%) | 1 [Reference] | - |
| >40 | 408 (13.8%) | 10 (16.4%) | 1.22 (0.62-2.42, P=0.568) | - |
| D-dimer (ng/mL) | ||||
| ≤0.5 | 2097 (71.1%) | 21 (34.4%) | 1 [Reference] | 1 [Reference] |
| >0.5 | 852 (28.9%) | 40 (65.6%) | 4.69 (2.75-8.00, P<0.001) | 3.76 (2.10-6.72, P<0.001) |
| Type of surgery | ||||
| ENT, ophthalamic, oral surgery and minor surgery | 446 (15.1%) | 5 (8.2%) | 0.50 (0.20-1.26, P=0.141) | - |
| Hepatobiliary pancreatic splenic surgery | 604 (20.5%) | 9 (14.8%) | 0.67 (0.33-1.37, P=0.275) | - |
| Orthopedic surgery | 298 (10.1%) | 2 (3.3%) | 0.30 (0.07-1.24, P=0.097) | - |
| Pelvic surgery | 373 (12.6%) | 10 (16.4%) | 1.35 (0.68-2.69, P=0.387) | - |
| Nervous system surgery | 430 (14.6%) | 6 (9.8%) | 0.64 (0.27-1.49, P=0.301) | - |
| Gastrointestinal surgery | 471 (16%) | 13 (21.3%) | 1.42 (0.77-2.65, P=0.264) | - |
| Thoracic and vascular surgery | 327 (11.1%) | 16 (26.2%) | 2.85 (1.59-5.10, P<0.001) | 3.25 (1.72-6.11, P<0.001) |
表4 低危异常心电图组MACE的风险预测因素(开发队列)
Tab.4 Risk predictors of MACE in patients with low-risk abnormal ECG in model development cohort
| Characteristic | MACE No. (%) (n=3010) | OR (univariable) | OR (multivariable) | |
|---|---|---|---|---|
| Negative (n=2949) | Positive (n=61) | |||
| Gender | ||||
| Female | 1281 (43.4%) | 22 (36.1%) | 1 [Reference] | - |
| Male | 1668 (56.6%) | 39 (63.9%) | 1.36 (0.80-2.31, P=0.252) | - |
| Age (year) | ||||
| <75 | 2404 (81.5%) | 42 (68.9%) | 1 [Reference] | 1 [Reference] |
| ≥75 | 545 (18.5%) | 19 (31.1%) | 2.00 (1.15-3.46, P=0.014) | 1.52 (0.83-2.77, P=0.174) |
| BMI (kg/m2) | ||||
| 18-24 | 1240 (42%) | 27 (44.3%) | 1 [Reference] | - |
| <18 | 82 (2.8%) | 2 (3.3%) | 1.12 (0.26-4.79, P=0.878) | - |
| >24 | 1627 (55.2%) | 32 (52.5%) | 0.90 (0.54-1.52, P=0.700) | - |
| Medical condition | ||||
| Hypertension | 1399 (47.4%) | 35 (57.4%) | 1.49 (0.89-2.49, P=0.126) | - |
| Cerebrovascular disease | 218 (7.4%) | 6 (9.8%) | 1.37 (0.58-3.21, P=0.473) | - |
| Diabetes | 730 (24.8%) | 13 (21.3%) | 0.82 (0.44-1.53, P=0.538) | - |
| Coronary artery disease | 346 (11.7%) | 19 (31.1%) | 3.40 (1.96-5.92, P<0.001) | 2.74 (1.46-5.14, P=0.002) |
| Arrhythmia | 425 (14.4%) | 11 (18%) | 1.31 (0.67-2.53, P=0.428) | - |
| Valvular heart disease | 11 (0.4%) | 1 (1.6%) | 4.45 (0.57-35.03, P=0.156) | - |
| Myocardial infarction | 28 (0.9%) | 4 (6.6%) | 7.32 (2.49-21.56, P<0.001) | 1.45 (0.39-5.41, P=0.584) |
| Congestive heart failure | 3 (0.1%) | 2 (3.3%) | 33.29 (5.46-202.93, P<0.001) | 32.50 (4.44-237.91, P<0.001) |
| Hepatic insufficiency | 165 (5.6%) | 3 (4.9%) | 0.87 (0.27-2.81, P=0.820) | - |
| Renal insufficiency | 43 (1.5%) | 1 (1.6%) | 1.13 (0.15-8.31, P=0.907) | - |
| RBC (1012/L) | ||||
| 3.5-5.5 | 2722 (92.3%) | 47 (77%) | 1 [Reference] | 1 [Reference] |
| >5.5 | 30 (1%) | 0 (0%) | 0.00 (0.00-Inf, P=0.985) | 0.00 (0.00-Inf, P=0.982) |
| <3.5 | 197 (6.7%) | 14 (23%) | 4.12 (2.23-7.61, P<0.001) | 2.49 (0.95-6.50, P=0.062) |
| PLT (109/L) | ||||
| 100-300 | 2604 (88.3%) | 52 (85.2%) | 1 [Reference] | - |
| <100 | 69 (2.3%) | 0 (0%) | 0.00 (0.00-Inf, P=0.977) | - |
| >300 | 276 (9.4%) | 9 (14.8%) | 1.63 (0.80-3.35, P=0.181) | - |
| HGB (g/L) | ||||
| 110-160 | 2555 (86.6%) | 42 (68.9%) | 1 [Reference] | 1 [Reference] |
| >160 | 80 (2.7%) | 4 (6.6%) | 3.04 (1.06-8.69, P=0.038) | 4.83 (1.55-15.07, P=0.007) |
| <110 | 314 (10.6%) | 15 (24.6%) | 2.91 (1.59-5.30, P<0.001) | 0.86 (0.34-2.15, P=0.750) |
| WBC (109/L) | ||||
| 4-10 | 2582 (87.6%) | 47 (77%) | 1 [Reference] | 1 [Reference] |
| <4 | 262 (8.9%) | 4 (6.6%) | 0.84 (0.30-2.35, P=0.738) | 0.97 (0.33-2.83, P=0.951) |
| >10 | 105 (3.6%) | 10 (16.4%) | 5.23 (2.57-10.64, P<0.001) | 3.88 (1.79-8.41, P<0.001) |
| Cr (µmmol/L) | ||||
| 44-110 | 2781 (94.3%) | 48 (78.7%) | 1 [Reference] | 1 [Reference] |
| <44 | 40 (1.4%) | 2 (3.3%) | 2.90 (0.68-12.33, P=0.150) | 1.65 (0.31-8.73, P=0.556) |
| >110 | 128 (4.3%) | 11 (18%) | 4.98 (2.53-9.82, P<0.001) | 3.63 (1.73-7.62, P<0.001) |
| GLU (mmol/L) | ||||
| 3.4-6.1 | 2340 (79.3%) | 47 (77%) | 1 [Reference] | - |
| <3.4 | 13 (0.4%) | 0 (0%) | 0.00 (0.00-Inf, P=0.985) | - |
| >6.1 | 596 (20.2%) | 14 (23%) | 1.17 (0.64-2.14, P=0.611) | - |
| APTT (s) | ||||
| ≤40 | 2541 (86.2%) | 51 (83.6%) | 1 [Reference] | - |
| >40 | 408 (13.8%) | 10 (16.4%) | 1.22 (0.62-2.42, P=0.568) | - |
| D-dimer (ng/mL) | ||||
| ≤0.5 | 2097 (71.1%) | 21 (34.4%) | 1 [Reference] | 1 [Reference] |
| >0.5 | 852 (28.9%) | 40 (65.6%) | 4.69 (2.75-8.00, P<0.001) | 3.76 (2.10-6.72, P<0.001) |
| Type of surgery | ||||
| ENT, ophthalamic, oral surgery and minor surgery | 446 (15.1%) | 5 (8.2%) | 0.50 (0.20-1.26, P=0.141) | - |
| Hepatobiliary pancreatic splenic surgery | 604 (20.5%) | 9 (14.8%) | 0.67 (0.33-1.37, P=0.275) | - |
| Orthopedic surgery | 298 (10.1%) | 2 (3.3%) | 0.30 (0.07-1.24, P=0.097) | - |
| Pelvic surgery | 373 (12.6%) | 10 (16.4%) | 1.35 (0.68-2.69, P=0.387) | - |
| Nervous system surgery | 430 (14.6%) | 6 (9.8%) | 0.64 (0.27-1.49, P=0.301) | - |
| Gastrointestinal surgery | 471 (16%) | 13 (21.3%) | 1.42 (0.77-2.65, P=0.264) | - |
| Thoracic and vascular surgery | 327 (11.1%) | 16 (26.2%) | 2.85 (1.59-5.10, P<0.001) | 3.25 (1.72-6.11, P<0.001) |
| Characteristic | MACE No. (%) (n=1904) | OR (univariable) | OR (multivariable) | |
|---|---|---|---|---|
| Negative (n=1845) | Positive (n=59) | |||
| Gender | ||||
| Female | 854 (46.3%) | 33 (55.9%) | 1 [Reference] | 1 [Reference] |
| Male | 991 (53.7%) | 26 (44.1%) | 0.68 (0.40-1.14, P=0.146) | - |
| Age (year) | ||||
| <75 | 1454 (78.8%) | 38 (64.4%) | 1 [Reference] | 1 [Reference] |
| ≥75 | 391 (21.2%) | 21 (35.6%) | 2.06 (1.19-3.54, P=0.009) | 1.42 (0.79-2.54, P=0.239) |
| Facility | 28 (1.5%) | 1 (1.7%) | 1.12 (0.15-8.36, P=0.913) | - |
| ASA grade | ||||
| Ⅰ | 12 (0.7%) | 0 (0%) | 1 [Reference] | - |
| Ⅱ | 1365 (74%) | 31 (52.5%) | - | - |
| Ⅲ | 451 (24.4%) | 24 (40.7%) | - | - |
| Ⅳ | 17 (0.9%) | 4 (6.8%) | - | - |
| BMI (kg/m2) | ||||
| 18-24 | 779 (42.2%) | 18 (30.5%) | 1 [Reference] | |
| <18 | 50 (2.7%) | 1 (1.7%) | 0.87 (0.11-6.62, P=0.889) | - |
| >24 | 1016 (55.1%) | 40 (67.8%) | 1.70 (0.97-2.99, P=0.064) | - |
| Smoking | 143 (7.8%) | 2 (3.4%) | 0.42 (0.10-1.73, P=0.228) | - |
| Drinking | 444 (24.1%) | 10 (16.9%) | 0.64 (0.32-1.28, P=0.210) | - |
| Medical condition | ||||
| Hypertension | 1018 (55.2%) | 37 (62.7%) | 1.37 (0.80-2.33, P=0.253) | - |
| Cerebrovascular disease | 170 (9.2%) | 5 (8.5%) | 0.91 (0.36-2.31, P=0.847) | - |
| Diabetes | 489 (26.5%) | 19 (32.2%) | 1.32 (0.76-2.30, P=0.331) | - |
| Coronary artery disease | 343 (18.6%) | 15 (25.4%) | 1.49 (0.82-2.71, P=0.189) | - |
| Arrhythmia | 389 (21.1%) | 25 (42.4%) | 2.75 (1.62-4.67, P<0.001) | 2.03 (1.13-3.65, P=0.017) |
| Valvular heart disease | 15 (0.8%) | 2 (3.4%) | 4.28 (0.96-19.16, P=0.057) | - |
| Myocardial infarction | 50 (2.7%) | 2 (3.4%) | 1.26 (0.30-5.30, P=0.753) | - |
| Congestive heart failure | 7 (0.4%) | 2 (3.4%) | 9.21 (1.87-45.33, P=0.006) | 2.36 (0.37-15.04, P=0.365) |
| COPD | 36 (2%) | 1 (1.7%) | 0.87 (0.12-6.43, P=0.888) | - |
| Malignant tumor | 127 (6.9%) | 2 (3.4%) | 0.47 (0.11-1.97, P=0.304) | - |
| Hepatic insufficiency | 98 (5.3%) | 4 (6.8%) | 1.30 (0.46-3.65, P=0.623) | - |
| Renal insufficiency | 23 (1.2%) | 4 (6.8%) | 5.76 (1.93-17.22, P=0.002) | 3.57 (1.03-12.45, P=0.045) |
| Peripheral artery disease | 47 (2.5%) | 3 (5.1%) | 2.05 (0.62-6.78, P=0.240) | - |
| Cardiac intervention | 119 (6.4%) | 4 (6.8%) | 1.05 (0.38-2.96, P=0.919) | - |
| RBC (1012/L) | ||||
| 3.5-5.5 | 1680 (91.1%) | 50 (84.7%) | 1 [Reference] | 1 [Reference] |
| >5.5 | 18 (1%) | 1 (1.7%) | 1.87 (0.24-14.26, P=0.547) | - |
| <3.5 | 147 (8%) | 8 (13.6%) | 1.83 (0.85-3.93, P=0.122) | - |
| PLT (109/L) | ||||
| 100-300 | 1584 (85.9%) | 51 (86.4%) | 1 [Reference] | 1 [Reference] |
| <100 | 45 (2.4%) | 0 (0%) | - | - |
| >300 | 216 (11.7%) | 8 (13.6%) | 1.15 (0.54-2.46, P=0.718) | - |
| HGB (g/L) | ||||
| 110-160 | 1576 (85.4%) | 48 (81.4%) | 1 [Reference] | 1 [Reference] |
| >160 | 54 (2.9%) | 1 (1.7%) | 0.61 (0.08-4.49, P=0.626) | - |
| <110 | 215 (11.7%) | 10 (16.9%) | 1.53 (0.76-3.06, P=0.233) | - |
| HCT (%) | ||||
| 35-50 | 1457 (79%) | 43 (72.9%) | 1 [Reference] | 1 [Reference] |
| >50 | 13 (0.7%) | 0 (0%) | - | - |
| <35 | 375 (20.3%) | 16 (27.1%) | 1.45 (0.81-2.60, P=0.217) | - |
| CRP (mg/L) | ||||
| ≤8 | 1810 (98.1%) | 58 (98.3%) | 1 [Reference] | 1 [Reference] |
| >8 | 35 (1.9%) | 1 (1.7%) | 0.89 (0.12-6.62, P=0.911) | - |
| WBC (109/L) | ||||
| 4-10 | 1614 (87.5%) | 53 (89.8%) | 1 [Reference] | 1 [Reference] |
| <4 | 155 (8.4%) | 2 (3.4%) | 0.39 (0.09-1.63, P=0.198) | - |
| >10 | 76 (4.1%) | 4 (6.8%) | 1.60 (0.57-4.54, P=0.375) | - |
| ALB (g/L) | ||||
| 35-55 | 1662 (90.1%) | 48 (81.4%) | 1 [Reference] | 1 [Reference] |
| <35 | 183 (9.9%) | 11 (18.6%) | 2.08 (1.06-4.08, P=0.033) | 1.12 (0.55-2.31, P=0.751) |
| Cr (µmmol/L) | ||||
| 44-110 | 1725 (93.5%) | 53 (89.8%) | 1 [Reference] | 1 [Reference] |
| <44 | 30 (1.6%) | 2 (3.4%) | 2.17 (0.51-9.32, P=0.297) | - |
| >110 | 90 (4.9%) | 4 (6.8%) | 1.45 (0.51-4.09, P=0.486) | - |
| Glu (mmol/L) | ||||
| 3.4-6.1 | 1420 (77%) | 38 (64.4%) | 1 [Reference] | 1 [Reference] |
| <3.4 | 13 (0.7%) | 0 (0%) | - | 0.00 (0.00-Inf, P=0.984) |
表5 高危异常心电图组MACE的风险预测因素(开发队列)
Tab.5 Risk predictors of MACE in patients with high-risk abnormal ECG in model development cohort
| Characteristic | MACE No. (%) (n=1904) | OR (univariable) | OR (multivariable) | |
|---|---|---|---|---|
| Negative (n=1845) | Positive (n=59) | |||
| Gender | ||||
| Female | 854 (46.3%) | 33 (55.9%) | 1 [Reference] | 1 [Reference] |
| Male | 991 (53.7%) | 26 (44.1%) | 0.68 (0.40-1.14, P=0.146) | - |
| Age (year) | ||||
| <75 | 1454 (78.8%) | 38 (64.4%) | 1 [Reference] | 1 [Reference] |
| ≥75 | 391 (21.2%) | 21 (35.6%) | 2.06 (1.19-3.54, P=0.009) | 1.42 (0.79-2.54, P=0.239) |
| Facility | 28 (1.5%) | 1 (1.7%) | 1.12 (0.15-8.36, P=0.913) | - |
| ASA grade | ||||
| Ⅰ | 12 (0.7%) | 0 (0%) | 1 [Reference] | - |
| Ⅱ | 1365 (74%) | 31 (52.5%) | - | - |
| Ⅲ | 451 (24.4%) | 24 (40.7%) | - | - |
| Ⅳ | 17 (0.9%) | 4 (6.8%) | - | - |
| BMI (kg/m2) | ||||
| 18-24 | 779 (42.2%) | 18 (30.5%) | 1 [Reference] | |
| <18 | 50 (2.7%) | 1 (1.7%) | 0.87 (0.11-6.62, P=0.889) | - |
| >24 | 1016 (55.1%) | 40 (67.8%) | 1.70 (0.97-2.99, P=0.064) | - |
| Smoking | 143 (7.8%) | 2 (3.4%) | 0.42 (0.10-1.73, P=0.228) | - |
| Drinking | 444 (24.1%) | 10 (16.9%) | 0.64 (0.32-1.28, P=0.210) | - |
| Medical condition | ||||
| Hypertension | 1018 (55.2%) | 37 (62.7%) | 1.37 (0.80-2.33, P=0.253) | - |
| Cerebrovascular disease | 170 (9.2%) | 5 (8.5%) | 0.91 (0.36-2.31, P=0.847) | - |
| Diabetes | 489 (26.5%) | 19 (32.2%) | 1.32 (0.76-2.30, P=0.331) | - |
| Coronary artery disease | 343 (18.6%) | 15 (25.4%) | 1.49 (0.82-2.71, P=0.189) | - |
| Arrhythmia | 389 (21.1%) | 25 (42.4%) | 2.75 (1.62-4.67, P<0.001) | 2.03 (1.13-3.65, P=0.017) |
| Valvular heart disease | 15 (0.8%) | 2 (3.4%) | 4.28 (0.96-19.16, P=0.057) | - |
| Myocardial infarction | 50 (2.7%) | 2 (3.4%) | 1.26 (0.30-5.30, P=0.753) | - |
| Congestive heart failure | 7 (0.4%) | 2 (3.4%) | 9.21 (1.87-45.33, P=0.006) | 2.36 (0.37-15.04, P=0.365) |
| COPD | 36 (2%) | 1 (1.7%) | 0.87 (0.12-6.43, P=0.888) | - |
| Malignant tumor | 127 (6.9%) | 2 (3.4%) | 0.47 (0.11-1.97, P=0.304) | - |
| Hepatic insufficiency | 98 (5.3%) | 4 (6.8%) | 1.30 (0.46-3.65, P=0.623) | - |
| Renal insufficiency | 23 (1.2%) | 4 (6.8%) | 5.76 (1.93-17.22, P=0.002) | 3.57 (1.03-12.45, P=0.045) |
| Peripheral artery disease | 47 (2.5%) | 3 (5.1%) | 2.05 (0.62-6.78, P=0.240) | - |
| Cardiac intervention | 119 (6.4%) | 4 (6.8%) | 1.05 (0.38-2.96, P=0.919) | - |
| RBC (1012/L) | ||||
| 3.5-5.5 | 1680 (91.1%) | 50 (84.7%) | 1 [Reference] | 1 [Reference] |
| >5.5 | 18 (1%) | 1 (1.7%) | 1.87 (0.24-14.26, P=0.547) | - |
| <3.5 | 147 (8%) | 8 (13.6%) | 1.83 (0.85-3.93, P=0.122) | - |
| PLT (109/L) | ||||
| 100-300 | 1584 (85.9%) | 51 (86.4%) | 1 [Reference] | 1 [Reference] |
| <100 | 45 (2.4%) | 0 (0%) | - | - |
| >300 | 216 (11.7%) | 8 (13.6%) | 1.15 (0.54-2.46, P=0.718) | - |
| HGB (g/L) | ||||
| 110-160 | 1576 (85.4%) | 48 (81.4%) | 1 [Reference] | 1 [Reference] |
| >160 | 54 (2.9%) | 1 (1.7%) | 0.61 (0.08-4.49, P=0.626) | - |
| <110 | 215 (11.7%) | 10 (16.9%) | 1.53 (0.76-3.06, P=0.233) | - |
| HCT (%) | ||||
| 35-50 | 1457 (79%) | 43 (72.9%) | 1 [Reference] | 1 [Reference] |
| >50 | 13 (0.7%) | 0 (0%) | - | - |
| <35 | 375 (20.3%) | 16 (27.1%) | 1.45 (0.81-2.60, P=0.217) | - |
| CRP (mg/L) | ||||
| ≤8 | 1810 (98.1%) | 58 (98.3%) | 1 [Reference] | 1 [Reference] |
| >8 | 35 (1.9%) | 1 (1.7%) | 0.89 (0.12-6.62, P=0.911) | - |
| WBC (109/L) | ||||
| 4-10 | 1614 (87.5%) | 53 (89.8%) | 1 [Reference] | 1 [Reference] |
| <4 | 155 (8.4%) | 2 (3.4%) | 0.39 (0.09-1.63, P=0.198) | - |
| >10 | 76 (4.1%) | 4 (6.8%) | 1.60 (0.57-4.54, P=0.375) | - |
| ALB (g/L) | ||||
| 35-55 | 1662 (90.1%) | 48 (81.4%) | 1 [Reference] | 1 [Reference] |
| <35 | 183 (9.9%) | 11 (18.6%) | 2.08 (1.06-4.08, P=0.033) | 1.12 (0.55-2.31, P=0.751) |
| Cr (µmmol/L) | ||||
| 44-110 | 1725 (93.5%) | 53 (89.8%) | 1 [Reference] | 1 [Reference] |
| <44 | 30 (1.6%) | 2 (3.4%) | 2.17 (0.51-9.32, P=0.297) | - |
| >110 | 90 (4.9%) | 4 (6.8%) | 1.45 (0.51-4.09, P=0.486) | - |
| Glu (mmol/L) | ||||
| 3.4-6.1 | 1420 (77%) | 38 (64.4%) | 1 [Reference] | 1 [Reference] |
| <3.4 | 13 (0.7%) | 0 (0%) | - | 0.00 (0.00-Inf, P=0.984) |
图3 决策曲线分析
Fig.3 Decision curve analysis (DCA). A: DCA for simple low-risk abnormal ECGs; B: DCA for low-risk abnormal ECGs with certain risk factors; C: DCA for high-risk abnormal ECGs.
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