Assessment of Euroscore and SAPS III as hospital mortality predicted in cardiac surgery

Mateos-Pañero, B.; Sánchez-Casado, M.; Castaño-Moreira, B.; Paredes-Astillero, I.; López-Álmodovar, Luis F.; Bustos-Molina, Filadelfo

doi:10.1016/j.redare.2017.03.002

Cited by 4 publications

(2 citation statements)

References 29 publications

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“…El metaanálisis de Guida, et al 3 , que incluyó 22 estudios, mostró una discriminación global de 0.79, similar a la de nuestro estudio. Las publicaciones más recientes, no incluidas aún en una revisión sistemática, son algunas de las siguientes: Irán 21 , China 22,23 , Grecia 24 , España 25,26 , India 27 , EE.UU. 28,29 y Países Bajos 30 , con áreas ROC que varían entre 0.67 y 0.87.…”

Section: Discussionunclassified

Validación prospectiva multicéntrica del EuroSCORE II en Argentina

Borracci

Rubio

Baldi

et al. 2020

ACM

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Entre enero de 2012 y febrero de 2018 se incluyeron en forma prospectiva 2,000 pacientes consecutivos que fueron sometidos a cirugía cardíaca en diferentes centros de Argentina. El punto final fue mortalidad hospitalaria por cualquier causa. La discriminación, calibración, precisión y utilidad clínica del EuroSCORE II se evaluaron en la cohorte global y en los diferentes tipos de cirugías, basándose en las curvas Receiver Operating Characteristics (ROC), bondad de ajuste de Hosmer-Lemeshow, razón de mortalidad observada/esperada, índice de Shannon y curvas de decisión. Resultados: El área ROC del EuroSCORE II estuvo entre 0.73 y 0.80 para todo tipo de cirugía, y el valor más bajo fue para la cirugía coronaria. La mortalidad observada y esperada fue 4.3 y 3.0%, respectivamente (p = 0.034). El análisis de la curva de decisión demostró un beneficio neto positivo para los umbrales por debajo de 0.24 para todo tipo de cirugía. Conclusiones: El EuroSCORE II tuvo un desempeño adecuado en términos de discriminación y calibración para todos los tipos de cirugía, aunque algo inferior para la cirugía coronaria. Si bien en términos generales subestimó el riesgo en los grupos de riesgo intermedio, el comportamiento global fue aceptable. El EuroSCORE II podría considerarse una opción de modelo genérico y actualizado de estratificación del riesgo operatorio para predecir la mortalidad hospitalaria de la cirugía cardíaca en nuestro contexto.

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Section: Discussionunclassified

Validación prospectiva multicéntrica del EuroSCORE II en Argentina

Borracci

Rubio

Baldi

et al. 2020

ACM

View full text Add to dashboard Cite

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“…The meta-analysis by Guida et al 3 , which included 22 studies, showed overall discrimination of 0.79, similar to that in our study. The most recent publications, not included yet in a systematic review, include some of the following: Iran 21 , China 22,23 , Greece 24 , Spain 25,26 , India 27 , US 28,29 , and the Netherlands 30 , with ROC areas ranging from 0.67 to 0.87.…”

Section: Discussionmentioning

confidence: 99%

Multicenter prospective validation of the European System for Cardiac Operative Risk Evaluation II in Argentina

Borracci¹,

Rubio²,

Baldi-Jr³

et al. 2020

ACME

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Objective: To validate prospectively in multiple centers, the accuracy and clinical utility of the European System for Cardiac Operative Risk Evaluation (EuroSCORE II) to predict the operative mortality of cardiac surgery in Argentina. Methods: Between January 2012 and February 2018, 2000 consecutive adult patients who underwent cardiac surgery in different centers in Argentina were prospectively included. The endpoint was in-hospital all-cause mortality. Discrimination, calibration, precision, and clinical utility of the EuroSCORE II were evaluated in the global cohort and in the different types of surgeries, based on receiver operating characteristics (ROC) curves, Hosmer-Lemeshow goodness-of-fit test, observed/expected mortality ratio, Shannon index, and decision curves analysis. Results: ROC area of the EuroSCORE II was between 0.73 and 0.80 for all types of surgery, being the lowest value for coronary surgery. The observed and expected mortality was 4.3% and 3.0%, respectively (p = 0.034). The decision curve analysis showed a positive net benefit for all thresholds below 0.24, considering all type of surgeries. Conclusions: The EuroSCORE II showed an adequate performance in terms of discrimination and calibration for all types of surgery, although somewhat inferior for coronary surgery. Although, in general terms, this model underestimated the risk in intermediate-risk groups, its overall performance was acceptable. The EuroSCORE II could be considered an optional updated generic model of operative risk stratification to predict in-hospital mortality after cardiac surgery in our context.

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Minimum heart rate and mortality after cardiac surgery: retrospective analysis of the Multi-parameter Intelligent Monitoring in Intensive Care (MIMIC-III) database

Luo

Duan

Liu

et al. 2023

Sci Rep

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Low heart rate is a risk factor of mortality in many cardiovascular diseases. However, the relationship of minimum heart rate (MHR) with outcomes after cardiac surgery is still unclear, and the association between optimum MHR and risk of mortality in patients receiving cardiac surgery remains unknown. In this retrospective study using the Multi-parameter Intelligent Monitoring in Intensive Care (MIMIC-III) database, 8243 adult patients who underwent cardiac surgery were included. The association between MHR and the 30-day, 90-day, 180-day, and 1-year mortality of patients undergoing cardiac surgery was analyzed using multivariate Cox proportional hazard analysis. As a continuous variable, MHR was evaluated using restricted cubic regression splines, and appropriate cut-off points were determined. Kaplan–Meier curve was used to further explore the relationship between MHR and prognosis. Subgroup analyses were performed based on age, sex, hypertension, diabetes, and ethnicity. The rates of the 30-day, 90-day, 180-day, and 1-year mortalities of patients in the low MHR group were higher than those in the high MHR group (4.1% vs. 2.9%, P < 0.05; 6.8% vs. 5.3%, P < 0.05; 8.9% vs. 7.0%, P < 0.05, and 10.9% vs. 8.8%, P < 0.05, respectively). Low MHR significantly correlated with the 30-day, 90-day, 180-day, and 1-year mortality after adjusting for confounders. A U-shaped relationship was observed between the 30-day, 90-day, 180-day, and 1-year mortality and MHR, and the mortality was lowest when the MHR was 69 bpm. Kaplan–Meier curve analysis also indicated that low MHR had poor prognosis in patients undergoing cardiac surgery. According to subgroup analyses, the effect of low MHR on post-cardiac surgery survival was restricted to patients who were < 75 years old, male, without hypertension and diabetes, and of White ethnicity. MHR (69 bpm) was associated with better 30-day, 90-day, 180-day, and 1-year survival in patients after cardiac surgery. Therefore, effective HR control strategies are required in this high-risk population.

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Assessment of Euroscore and SAPS III as hospital mortality predicted in cardiac surgery

Cited by 4 publications

References 29 publications

Validación prospectiva multicéntrica del EuroSCORE II en Argentina

Validación prospectiva multicéntrica del EuroSCORE II en Argentina

Multicenter prospective validation of the European System for Cardiac Operative Risk Evaluation II in Argentina

Minimum heart rate and mortality after cardiac surgery: retrospective analysis of the Multi-parameter Intelligent Monitoring in Intensive Care (MIMIC-III) database

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