BackgroundThe applicability of international risk scores in heart surgery (HS) is not
well defined in centers outside of North America and Europe.ObjectiveTo evaluate the capacity of the Parsonnet Bernstein 2000 (BP) and EuroSCORE
(ES) in predicting in-hospital mortality (IHM) in patients undergoing HS at
a reference hospital in Brazil and to identify risk predictors (RP).MethodsRetrospective cohort study of 1,065 patients, with 60.3% patients underwent
coronary artery bypass grafting (CABG), 32.7%, valve surgery and 7.0%, CABG
combined with valve surgery. Additive and logistic scores models, the area
under the ROC (Receiver Operating Characteristic) curve (AUC) and the
standardized mortality ratio (SMR) were calculated. Multivariate logistic
regression was performed to identify the RP.ResultsOverall mortality was 7.8%. The baseline characteristics of the patients were
significantly different in relation to BP and ES. AUCs of the logistic and
additive BP were 0.72 (95% CI, from 0.66 to 0.78 p = 0.74), and of ES they
were 0.73 (95% CI; 0.67 to 0.79 p = 0.80). The calculation of the SMR in BP
was 1.59 (95% CI; 1.27 to 1.99) and in ES, 1.43 (95% CI; 1.14 to 1.79).
Seven RP of IHM were identified: age, serum creatinine > 2.26 mg/dL,
active endocarditis, systolic pulmonary arterial pressure > 60 mmHg, one
or more previous HS, CABG combined with valve surgery and diabetes
mellitus.ConclusionLocal scores, based on the real situation of local populations, must be
developed for better assessment of risk in cardiac surgery.