Scoring Systems for Outcome Prediction in a Cardiac Surgical Intensive Care Unit: A Comparative Study

Exarchopoulos, Themistocles; Charitidou, Efstratia; Dedeilias, Panagiotis; Charitos, Christos; Routsi, Christina

doi:10.4037/ajcc2015500

Cited by 35 publications

(43 citation statements)

References 28 publications

(31 reference statements)

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“…(16) Exarchopoulos et al noted that SOFA score is one of the most significant predictors of mortality and in-hospital postoperative comorbidities in cardiac surgery patients. (17) …”

Section: Discussionmentioning

confidence: 99%

Reintubation of patients submitted to cardiac surgery: a retrospective analysis

Shoji¹,

Figuereido²,

Calixtre³

et al. 2017

Revista Brasileira De Terapia Intensiva

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ObjectivesTo analyze patients after cardiac surgery that needed endotracheal reintubation and identify factors associated with death and its relation with the severity scores.MethodsRetrospective analysis of information of 1,640 patients in the postoperative period of cardiac surgery between 2007 and 2015.ResultsThe reintubation rate was 7.26%. Of those who were reintubated, 36 (30.3%) underwent coronary artery bypass surgery, 27 (22.7%) underwent valve replacement, 25 (21.0%) underwent correction of an aneurysm, and 8 (6.7%) underwent a heart transplant. Among those with comorbidities, 54 (51.9%) were hypertensive, 22 (21.2%) were diabetic, and 10 (9.6%) had lung diseases. Among those who had complications, 61 (52.6%) had pneumonia, 50 (42.4%) developed renal failure, and 49 (51.0%) had a moderate form of the transient disturbance of gas exchange. Noninvasive ventilation was performed in 53 (44.5%) patients. The death rate was 40.3%, and mortality was higher in the group that did not receive noninvasive ventilation before reintubation (53.5%). Within the reintubated patients who died, the SOFA and APACHE II values were 7.9 ± 3.0 and 16.9 ± 4.5, respectively. Most of the reintubated patients (47.5%) belonged to the high-risk group, EuroSCORE (> 6 points).ConclusionThe reintubation rate was high, and it was related to worse SOFA, APACHE II and EuroSCORE scores. Mortality was higher in the group that did not receive noninvasive ventilation before reintubation.

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“…(16) Exarchopoulos et al noted that SOFA score is one of the most significant predictors of mortality and in-hospital postoperative comorbidities in cardiac surgery patients. (17) …”

Section: Discussionmentioning

confidence: 99%

Reintubation of patients submitted to cardiac surgery: a retrospective analysis

Shoji¹,

Figuereido²,

Calixtre³

et al. 2017

Revista Brasileira De Terapia Intensiva

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“…This chain reaction results in tissue perfusion defects, which eventually causes an increase in the mortality predicting score (APACHE-II) in an ICU setting. A previous study showed that APACHE-II scoring system is effective for predicting the mortality at an early period (23) . Furthermore, a study consisting of 523 cases, which was performed to detect ICU mortality, reported the usefulness of APACHE-II scoring system (24) .…”

Section: Discussionmentioning

confidence: 99%

Relation Between Cerebral Perfusion Changes and Mortality Scores During Cardiopulmonary Bypass at Adult Cardiac Surgery

Şen¹,

Yıldız²

2019

Kosuyolu Heart Journal

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Introduction: This study aims to investigate the correlation between cerebral perfusion changes and mortality rate in individuals undergoing adult cardiac surgery. Patients and Methods: Between April 2018-August 2018, 91 adult individuals who underwent open heart surgery with cardiopulmonary bypass (CPB) were prospectively evaluated. Cerebral perfusion was monitored via near-infrared spectroscopy (NIRS). The NIRS values were recorded at four intervals: T0, just before CPB; T1, cooling period (time taken to reach targeted hypothermia); T2, warming period (time taken to reach normal body temperature); and T3, following minutes of termination of CPB. Euro Score II and Acute Physiology and Chronic Health Evaluation (APACHE) II scores were recorded for each individual. Results: The operations performed include coronary artery bypass surgery (n= 41, 45%), valvular surgery (n= 47, 51%), and coronary artery bypass combined with valvular surgery (n= 3, 4%). Median Euro Score II was calculated to be 1.1 (range 0.7-36.6), and median APACHE II score was calculated to be 6 (range 0-23). Mortality occurred in four individuals for whom the Euro Score II C index was 0.702 (confidence interval, 0.411-0.993; p= 0.048) and APACHE-II score C index was 0.871 (confidence interval, 0.660-1; p= 0.010). During the operative period, cerebral NIRS values decreased during T3 period, and significant changes occurred at T0-T3 period, consequently leading to an increase in the APACHE-II scores and the prediction of mortality. Conclusion: The changes at NIRS values were related with higher mortality, morbidity, and predicting scores. It is now suggested that these changes can eventually be a good guide and predictor for the management of patients during preoperative and postoperative periods.

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“…The overall 30-day mortality was 10.3% which is considered to be higher than the average mortality reported in previous studies 9.3%, 9.6% and 6%. [11][12][13] This may be due to the higher rate of postoperative cardiac and respiratory 14 Many studies have been conducted on risk models after cardiac surgery estimating mortality and morbidity, but to date, there is no consensus regarding the best scoring system after cardiac surgery. 15 Our results showed that the preoperative score (EuroSCORE) underestimated the mortality risk in our patient population.…”

Section: Discussionmentioning

confidence: 99%

Outcome Prediction After Open Heart Surgery

Elhamshary

Serag

Sabry

et al. 2018

Egypt. Cardiothoracic. Surg.

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Abstract: Background: Mortality is the most commonly used outcome measure after cardiac surgery. Various risk scores were developed to predict mortality after cardiac surgery with many differences among these scores. We evaluated the accuracy of Acute Physiology And Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score and Cardiac Surgery Score (CASUS) in predicting mortality in our patient population. Methods: Between October 2015 and December 2017, 103 adult patients who underwent open heart surgery were evaluated. The clinical characteristics, outcomes and risk scores data of the patients were collected. Accuracy of the scores was assessed using receiver operating curve (ROC) and the multivariate logistic regression analysis. Results: 103 patients were enrolled with mortality rate of 10.3%. The non-survivors group showed statistically significant lower E.F, higher platelet count, higher bilirubin level and lower Po2 level (P value: 0.015, 0.020, 0.038, 0.006) respectively. Both APACHE II and SOFA scores performed better than CASUS score in predicting mortality in this study. However, APACHE II score (Area Under Curve “AUC”:0.878, sensitivity: 80%, specificity: 78.5%) and the preoperative platelet count independently predicted mortality after cardiac surgery. Conclusion: Both APACHE II and SOFA scores showed a high power in predicting mortality after cardiac surgery but APACHE II score rises as the best tool for risk stratification in our patient population. Keywords: Mortality; Cardiac surgery; Risk scores.

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Scoring Systems for Outcome Prediction in a Cardiac Surgical Intensive Care Unit: A Comparative Study

Cited by 35 publications

References 28 publications

Reintubation of patients submitted to cardiac surgery: a retrospective analysis

Reintubation of patients submitted to cardiac surgery: a retrospective analysis

Relation Between Cerebral Perfusion Changes and Mortality Scores During Cardiopulmonary Bypass at Adult Cardiac Surgery

Outcome Prediction After Open Heart Surgery

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