ObjectiveTo assess the performance of the Pediatric Index of Mortality (PIM) 2 and the
Risk Adjustment for Congenital Heart Surgery (RACHS) in the postoperative
period of congenital heart disease patients.MethodsRetrospective cross-sectional study. Data were collected from patient records
to generate the scores and predictions using recommended techniques,
demographic data and outcomes. The Mann-Whitney test, Hosmer-Lemeshow test,
standardized mortality rate, area under the receiver operating
characteristic (ROC) curve, chi square test, Poisson regression with robust
variance and Spearman's test were used for statistical analysis.ResultsA total of 263 patients were evaluated, and 72 died (27.4%). These patients
presented significantly higher PIM-2 values than survivors (p < 0.001).
In the RACHS-1 classification, mortality was progressively higher according
to the complexity of the procedure, with a 3.24-fold increase in the
comparison between groups 6 and 2. The area under the ROC curve for PIM-2
was 0.81 (95%CI 0.75 - 0.87), while for RACHS-1, it was 0.70 (95%CI 0.63 -
0.77). The RACHS presented better calibration power in the sample analyzed.
A significantly positive correlation was found between the results of both
scores (rs = 0.532; p < 0.001).ConclusionRACHS presented good calibration power, and RACHS-1 and PIM-2 demonstrated
good performance with regard to their discriminating capacities between
survivors and non-survivors. Moreover, a positive correlation was found
between the results of the two risk scores.
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