In search of the ideal risk-scoring system for very high-risk cardiac surgical patients: a two-stage approach

Journal of Cardiothoracic Surgery
Marco RanucciSurgical and Clinical Outcome Research (SCORE) Group

Abstract

Cardiac surgery patients at very high risk are difficult to stratify with the existing risk scores. The objective of this study is to assess the clinical performance of two existing risk stratification scores (EuroSCORE II and ACEF score) in the setting of very high-risk patients undergoing cardiac surgery, and to identify a possible strategy to better address this patient population. Three-thousand-four-hundred-twenty eight (3,428) consecutive adult patients receiving cardiac operations at a single institution were investigated. Patients having an operative mortality risk >25 % at either the EuroSCORE II or the ACEF score were selected (105 patients). The discrimination power and calibration of the EuroSCORE II and the ACEF score were investigated. Factors associated with operative mortality were included in a multivariable logistic regression model and a new model was re-built for this patient population. The observed mortality rate was 26 %. The expected mortality rate was underestimated by the EuroSCORE II (16 %) and overestimated by the ACEF Score (36 %). The EuroSCORE maintained a good discrimination (c-statistics 0.75) while the ACEF score did not (c-statistics 0.52). Within this patient population, the independent risk ...Continue Reading

References

Jul 11, 2007·Circulation·Alexander KulierUNKNOWN Ischemia Research and Education Foundation
Feb 23, 2010·The Annals of Thoracic Surgery·Ruyun JinGary L Grunkemeier
Nov 16, 2010·The Journal of Thoracic and Cardiovascular Surgery·Takehiro KimuraKeiichi Fukuda
Mar 2, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Samer A M NashefUlf Lockowandt
Jun 16, 2012·The Annals of Thoracic Surgery·Marco RanucciUNKNOWN Surgical and Clinical Outcome Research (SCORE) Group
Jul 24, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Umberto Di DeddaMarco Ranucci
Feb 1, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Domenico PaparellaTommaso Fiore
Apr 23, 2014·The Thoracic and Cardiovascular Surgeon·Lazar VelickiMiklos Fabri
Aug 7, 2014·Journal of Cardiothoracic Surgery·Antonio MiceliGianni D Angelini
Oct 29, 2014·Interactive Cardiovascular and Thoracic Surgery·Michael PoullisNeeraj Mediratta

❮ Previous
Next ❯

Citations

Aug 19, 2017·Current Opinion in Critical Care·Daniel Talmor, Barry Kelly
Apr 7, 2020·Minerva anestesiologica·Marco Ranucci
Mar 11, 2020·Minerva anestesiologica·Anna ZamperoniUNKNOWN Cardiac surgical intensive care writing committee (GiViTI)
Apr 11, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Ashleigh P PittamsAmer Harky

❮ Previous
Next ❯

Methods Mentioned

BETA
percutaneous transluminal coronary angioplasty

Software Mentioned

SPSS

Related Concepts

Related Feeds

Anemia

Anemia develops when your blood lacks enough healthy red blood cells. Anemia of inflammation (AI, also called anemia of chronic disease) is a common, typically normocytic, normochromic anemia that is caused by an underlying inflammatory disease. Here is the latest research on anemia.

Related Papers

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Sabrina SiregarLex A van Herwerden
European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Umberto Di DeddaMarco Ranucci
European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Carlos A MestresHospital Clínico Endocarditis Study Group
Interactive Cardiovascular and Thoracic Surgery
Marco RanucciACEF Score Research Group
© 2022 Meta ULC. All rights reserved