Mortality risk prediction in high-risk patients undergoing coronary artery bypass grafting: Are traditional risk scores accurate?

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Citações na Scopus
2
Tipo de produção
article
Data de publicação
2021
Título da Revista
ISSN da Revista
Título do Volume
Editora
PUBLIC LIBRARY SCIENCE
Autores
ARTHUR, Camila Perez de Souza
SOUSA, Alexandre
OLIVEIRA, Marco Antonio Praca
ATIK, Fernando Antibas
SEGALOTE, Rodrigo Coelho
TIVERON, Marcos Gradim
SILVA, Pedro Gabriel Melo de Barros e
Citação
PLOS ONE, v.16, n.8, article ID e0255662, 13p, 2021
Projetos de Pesquisa
Unidades Organizacionais
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Resumo
Background The performance of traditional scores is significantly limited to predict mortality in high-risk cardiac surgery. The aim of this study was to compare the performance of STS, ESII and HiriSCORE models in predicting mortality in high-risk patients undergoing CABG. Methods Cross-sectional analysis in the international prospective database of high-risk patients: HiriSCORE project. We evaluated 248 patients with STS or ESII (5-10%) undergoing CABG in 8 hospitals in Brazil and China. The main outcome was mortality, defined as all deaths occurred during the hospitalization in which the operation was performed, even after 30 days. Five variables were selected as predictors of mortality in this cohort of patients. The model's performance was evaluated through the calibration-in-the-large and the receiver operating curve (ROC) tests. Results The mean age was 69.90 +/- 9.45, with 52.02% being female, 25% of the patients were on New York Heart Association (NYHA) class IV and 49.6% had Canadian Cardiovascular Society (CCS) class 4 angina, and 85.5% had urgency or emergency status. The mortality observed in the sample was 13.31%. The HiriSCORE model showed better calibration (15.0%) compared to ESII (6.6%) and the STS model (2.0%). In the ROC curve, the HiriSCORE model showed better accuracy (ROC = 0.74) than the traditional models STS (ROC = 0.67) and ESII (ROC = 0.50). Conclusion Traditional models were inadequate to predict mortality of high-risk patients undergoing CABG. However, the HiriSCORE model was simple and accurate to predict mortality in high-risk patients.
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Referências
  1. Akkerhuis KM, 2000, EUR HEART J, V21, P371, DOI 10.1053/euhj.1999.1743
  2. Barili F, 2013, ANN THORAC SURG, V95, P1539, DOI 10.1016/j.athoracsur.2013.01.058
  3. Silva PGMDE, 2015, REV BRAS CIR CARDIOV, V30, P660, DOI 10.5935/1678-9741.20150075
  4. Englum BR, 2015, ANN THORAC SURG, V99, P856, DOI 10.1016/j.athoracsur.2014.09.048
  5. Lisboa LAF, 2014, REV BRAS CIR CARDIOV, V29, P1, DOI 10.5935/1678-9741.20140004
  6. Grant SW, 2013, CIRC-CARDIOVASC QUAL, V6, P178, DOI 10.1161/CIRCOUTCOMES.111.000018
  7. Gutacker N, 2015, EUR J PUBLIC HEALTH, V25, P28, DOI 10.1093/eurpub/cku228
  8. Howell NJ, 2013, EUR J CARDIO-THORAC, V44, P1006, DOI 10.1093/ejcts/ezt174
  9. Hu Z, 2020, ANN THORAC SURG, V109, P1234, DOI 10.1016/j.athoracsur.2019.08.020
  10. Kappetein AP, 2012, EUR J CARDIO-THORAC, V41, P732, DOI 10.1093/ejcts/ezs061
  11. Lapar DJ, 2014, J THORAC CARDIOV SUR, V148, P2686, DOI 10.1016/j.jtcvs.2014.06.086
  12. McNeely C, 2016, ANN THORAC SURG, V102, P132, DOI 10.1016/j.athoracsur.2016.01.016
  13. Nashef SAM, 2002, EUR J CARDIO-THORAC, V22, P101, DOI 10.1016/S1010-7940(02)00208-7
  14. Nashef SAM, 2012, EUR J CARDIO-THORAC, V41, P734, DOI 10.1093/ejcts/ezs043
  15. Neumann FJ, 2019, EUR HEART J, V40, P79, DOI 10.1093/eurheartj/ehy855
  16. Palma-Ruiz M, 2003, REV ESP CARDIOL, V56, P687, DOI 10.1157/13049651
  17. Ranucci M, 2016, J CARDIOTHORAC SURG, V11, DOI 10.1186/s13019-016-0405-3
  18. Ranucci M, 2009, EUR J CARDIO-THORAC, V36, P791, DOI 10.1016/j.ejcts.2009.02.023
  19. Schrutka L, 2019, EUR J CARDIO-THORAC, V56, P534, DOI 10.1093/ejcts/ezz040
  20. Sergeant P, 2001, EUR J CARDIO-THORAC, V20, P1176, DOI 10.1016/S1010-7940(01)01013-2
  21. Sergeant P, 2012, EUR J CARDIO-THORAC, V41, P729, DOI 10.1093/ejcts/ezs057
  22. Shahian DM, 2019, J THORAC CARDIOV SUR, V158, P110, DOI 10.1016/j.jtcvs.2018.12.072
  23. Shahian DM., 2009, ANN THORAC SURG, V88, pS2, DOI [10.1016/j.athoracsur.2009.05.053, DOI 10.1016/j.athoracsur.2009.05.053]
  24. Shih T, 2015, ANN THORAC SURG, V100, P516, DOI 10.1016/j.athoracsur.2015.02.085
  25. Tu JV, 1997, J AM COLL CARDIOL, V30, P1317, DOI 10.1016/S0735-1097(97)00295-7
  26. Mejia OAV, 2012, REV BRAS CIR CARDIOV, V27, P503, DOI 10.5935/1678-9741.20120091
  27. Mejia OAV, 2012, REV BRAS CIR CARDIOV, V27, P187, DOI 10.5935/1678-9741.20120033
  28. Yamaoka H, 2016, J CARDIOL, V68, P135, DOI 10.1016/j.jjcc.2015.08.017