Reply to “Developing a Risk Prediction Model for Intensive Care Unit Mortality after Cardiac Surgery”

Howitt, Samuel H.; Malagon, Ignacio; McCollum, Charles; Grant, Stuart W

doi:10.1055/s-0038-1639342

Cited by 2 publications

(5 citation statements)

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“…[9] However, the calibration of the logCASUS was poor and the predicted and observed mortality were more consistent after recalibration. [10][11][12] In a comprehensive retrospective study by Wilson et al, [10] logCASUS was shown to overpredict mortality after cardiac surgery and the expected and observed mortality were comparable after recalibration. However, Singh et al [11] reported in their retrospective study with 7,098 patients that logCASUS underpredicted mortality compared with additive CASUS after cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

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CASUS and APACHE II score in predicting mortality after coronary artery bypass grafting

Uğur,

Acarel,

Yapıcı

2023

Turk Gogus Kalp Dama

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Background: This study aims to compare Cardiac Surgery Score (CASUS) and the Acute Physiology and Chronic Health Evaluation (APACHE II) scoring systems for predicting mortality in patients undergoing isolated coronary artery bypass grafting. Methods: Between January 2019 and March 2019, a total of 204 patients (166 males, 38 females; mean age: 60.5±0.7 years; range, 59.2 to 61.9 years) who underwent isolated coronary artery bypass grafting and were monitored at least for 24 h in the intensive care unit postoperatively were included. Pre-, intra-, and postoperative data were recorded. The CASUS and APACHE II scores were calculated using the most abnormal values for each variable during the first 24 h, postoperatively. Clinical outcomes were seven-day mortality and 30-day mortality, need for reintubation, readmission to the intensive care unit, length of intensive care unit stay and length of hospital stay. Results: The 30-day overall mortality was 4.9% (n=10). The CASUS scores were significantly higher for patients developing mortality within 30 days postoperatively (p=0.030) and for patients needing reintubation (p=0.003). In the receiver operating characteristic curve analysis predicting seven-day mortality and prolonged intensive care unit stay, the area under curve was higher for CASUS scoring compared to APACHE II (0.90 vs. 0.72 and 0.82 vs. 0.76). Conclusion: The CASUS may prove to be a more reliable scoring system than APACHE II for predicting mortality and morbidity in patients undergoing isolated coronary artery bypass grafting.

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Section: Discussionmentioning

confidence: 99%

“…The logCASUS and RACE performed better after recalibration. [12] Changing treatment approaches and improvement in patient care may have highlighted need for recalibration. We used additive CASUS due to short ICU stay.…”

Section: Discussionmentioning

confidence: 99%

CASUS and APACHE II score in predicting mortality after coronary artery bypass grafting

Uğur,

Acarel,

Yapıcı

2023

Turk Gogus Kalp Dama

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“…Here, we show an important correlation between SOFA score at the ICU and long-term outcome, in terms of mortality at 12 and 24 months. SOFA score has already been validated for cardiac surgery patients, and it has been used as a predictor of ICU and 30-day mortality (7, 8). However, to our knowledge, postoperative SOFA score has not been correlated with long-term mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the SOFA score has been designed to report morbidity and to objectively quantify the degree of dysfunction/failure of each organ daily in critically ill patients (7). SOFA score is validated to be used after cardiac surgery and can be safely used to predict the degree of severity of postoperatory morbidity without specific adaptations (6)(7)(8).…”

Section: Observational Studymentioning

confidence: 99%

“…Outcome prediction is important in the management of patients in the ICU, especially for therapeutic decision and resource allocation (5). Several risk models have been developed in the past decades to analyze postoperative data and predict outcome (8). Some of these models designed for and in use in general ICU patients also accurately predict mortality after cardiac surgery (6, 9, 10), with the SOFA score generally demonstrating the best performance (8).…”

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confidence: 99%

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Sequential Organ Failure Assessment Score in the ICU As a Predictor of Long-Term Survival After Cardiac Surgery

Velho

Pereira

Paixão

et al. 2022

Critical Care Explorations

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OBJECTIVES: The Sequential Organ Failure Assessment (SOFA) score is a predictor of mortality in ICU patients. Although it is widely used and has been validated as a reliable and independent predictor of mortality and morbidity in cardiac ICU, few studies correlate early postoperative SOFA with long-term survival. DESIGN: Retrospective observational cohort study. SETTING: Tertiary academic cardiac surgery ICU. PATIENTS: One-thousand three-hundred seventy-nine patients submitted to cardiac surgery. INTERVENTIONS: SOFA 24 hours, SOFA 48 hours, mean, and highest SOFA scores were correlated with survival at 12 and 24 months. Wilcoxon tests were used to analyze differences in variables. Multivariate logistic regressions and likelihood ratio test were used to access the predictive modeling. Receiver operating characteristic curves were used to assess accuracy of the variables in separating survivor from nonsurvivors. MEASUREMENTS AND MAIN RESULTS: Lower SOFA scores have better survival rates at 12 and 24 months. Highest SOFA and SOFA at 48 hours showed to be better predictors of outcome and to have higher accuracy in distinguishing survivors from nonsurvivors than initial SOFA and mean SOFA. A decreasing score during the first 48 hours had mortality rates of 4.9%, while an unchanged or increased score was associated with a mortality rate of 5.7%. CONCLUSIONS: SOFA score in the ICU after cardiac surgery correlated with survival at 12 and 24 months. Patients with lower SOFA scores had higher survival rates. Differences in survival at 12 months were better correlated with the absolute value at 48 hours than with its variation. SOFA score may be useful to predict long-term outcomes and to stratify patients with higher probability of mortality.

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Reply to “Developing a Risk Prediction Model for Intensive Care Unit Mortality after Cardiac Surgery”

Cited by 2 publications

References 4 publications

CASUS and APACHE II score in predicting mortality after coronary artery bypass grafting

CASUS and APACHE II score in predicting mortality after coronary artery bypass grafting

Sequential Organ Failure Assessment Score in the ICU As a Predictor of Long-Term Survival After Cardiac Surgery

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