基于倾向性得分匹配的特定ICU患者PTCA临床结果分析

Analysis of PTCA Clinical Results of Specific ICU Patients Based on Propensity Score Matching

摘要: 为探究对于做PTCA手术的特定(心肺功能等异常) ICU患者与非手术ICU患者生存状况的差异。从eICU数据库中收集ICU患者数据148,532例，其中，接受PTCA手术治疗的患者8862例(PTCA手术组)，未接受PTCA手术治疗的患者139,670例(非手术组)。通过倾向性得分匹配(PSM)分析方法，运用1:1最近邻匹配来平衡组间各协变量之间的差异后，比较两组患者生存率的差异。通过倾向性得分匹配，两组共匹配出17,686例，PTCA手术组和非手术组各8843例。匹配前，除阿帕奇评分算法版本(Apache version)之外的组间各协变量之间的不均衡性明显(均有P < 0.001)。匹配后，PTCA手术组和非手术组的组间各协变量之间的分布特征接近(均有P > 0.001)；PTCA手术组的ICU患者的生存率明显优于非手术组(P < 0.001)。最终结果显示，对于特定的ICU患者做PTCA手术可明显改善其生存状况，故推荐可耐手术的特定ICU患者积极尝试PTCA手术这种治疗方案。

Abstract: To explore the difference between the survival status of ICU patients and non-surgical ICU patients who undergo PTCA surgery (abnormal cardiopulmonary function, etc.). The data of 148,532 ICU patients were collected from the eICU database. Among them, 8862 patients received PTCA surgery (PTCA surgery group), and 139,670 patients did not receive PTCA surgery (non-surgical group). After propensity score matching (PSM) analysis method, 1:1 nearest neighbor matching was used to balance the differences between the covariates between the groups, the differences in survival rates between the two groups were compared. Through propensity score matching, a total of 17,686 cases were matched between the two groups, 8443 cases in each of the PTCA operation group and the non-operation group. Before matching, the imbalance between the covariates among the groups other than the Apache version was obvious (All P < 0.001). After matching, the distribution characteristics of the covariates between the PTCA surgery group and the non-surgery group are similar (All P > 0.001); the survival rate of ICU patients in the PTCA surgery group is significantly better than that of the non-surgery group (P < 0.001). The final results show that PTCA surgery for specific ICU patients can significantly improve their survival. Therefore, it is recommended that specific ICU patients who are resistant to surgery actively try PTCA surgery.