EuroSCORE II and the importance of a local model, InsCor and the future SP-SCORE

Lisboa, Luiz Augusto Ferreira; Mejía, Omar Asdrúbal Vilca; Moreira, Luíz Felipe Pinho; Dallan, Luís Alberto; Pomerantzeff, Pablo Maria Alberto; Dallan, Luís Roberto Palma; Massoti, M.; Jatene, Fábio Biscegli

doi:10.5935/1678-9741.20140004

Cited by 24 publications

(24 citation statements)

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“…Lisboa et al [5] analyzed the performance of EuroSCORE II in 1000 patients undergoing cardiac surgery, comparing it to the InsCor and EuroSCORE. The authors concluded that only the last two were adequate in all stages of validation, due to mistakes in the design of EuroSCORE II, hence reinforcing the importance of a national risk score model.…”

Section: Discussionmentioning

confidence: 99%

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Mortality Risk After Cardiac Surgery: Application of Inscor in a University Hospital in Brazil's Northeast

Fortes¹,

Silva²,

Baldez³

et al. 2016

Brazilian Journal of Cardiovascular Surgery

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ObjectiveTo apply the InsCor in patients undergoing cardiac surgery in a university hospital in Brazil's northeast.MethodsIt is a retrospective, quantitative and analytical study, carried out at the University Hospital of the Federal University of Maranhão. InsCor is a remodeling of two risk score models. It evaluates the prediction of mortality through variables such as gender, age, type of surgery or reoperation, exams, and preoperative events. Data from January to December 2015 were collected, using a Physical Therapy Evaluation Form and medical records. Quantitative variables were expressed as mean and standard deviation and qualitative variables as absolute and relative frequencies. Fisher's exact and Kruskal-Wallis tests were applied, considering significant differences when P value was < 0.05. Calibration was performed by Hosmer-Lemeshow test.ResultsOne hundred and forty-eight patients were included. Thirty-six percent were female, with mean age of 54.7±15.8 years and mean body mass index (BMI) equal to 25.6 kg/m2. The most frequent surgery was coronary artery bypass grafting (51.3%). According to InsCor, 73.6% of the patients had low risk, 20.3% medium risk, and only 6.1% high risk. In this sample, 11 (7.4%) patients died. The percentage of death in patients classified as low, medium and high risk was 6.3, 7.1% and 11.1%, respectively.ConclusionInsCor presented easy applicability due to the reduced number of variables analyzed and it showed satisfactory prediction of mortality in this sample of cardiac surgery patients.

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Section: Discussionmentioning

confidence: 99%

“…Nevertheless, development and validation of local models are becoming increasingly necessary due to demographic, socioeconomic, and cultural aspects of different populations [4,5] . The combination of the data resulting from the risk score models allows for adaptation, improvement and even innovation in treatment programs [2] .…”

Section: Introductionmentioning

confidence: 99%

Mortality Risk After Cardiac Surgery: Application of Inscor in a University Hospital in Brazil's Northeast

Fortes¹,

Silva²,

Baldez³

et al. 2016

Brazilian Journal of Cardiovascular Surgery

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“…In Brazil, the first validation of the EuroSCORE II was performed by Lisboa et al. [ 15 ] , from the analysis of 1000 consecutive patients undergoing coronary and/or valve surgery.…”

Section: Discussionmentioning

confidence: 99%

InsCor and other three international scores performance in cardiac surgery at the Santa Casa de Marilia

Tiveron¹,

Bomfim²,

Simplício³

et al. 2014

Revista Brasileira De Cirurgia Cardiovascular

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ObjectiveTo apply and to compare the Society of Thoracic Surgery score (STS), EuroSCORE (Eurosc1), EuroSCORE II (Eurosc2) and InsCor (IS) for predicting mortality in patients undergoing to coronary artery bypass graft and/or valve surgery at the Santa Casa Marilia.Methods The present study is a cohort. It is a prospective, observational, analytical and unicentric. We analyzed 562 consecutive patients coronary artery bypass graft and/or valve surgery, between April 2011 and June 2013 at the Santa Casa Marilia. Mortality was calculated for each patient through the scores STS, Eurosc1, Eurosc2 and IS. The calibration was calculated using the Hosmer Lemeshow test and discrimination by ROC curve.ResultsThe hospital mortality was 4,6%. The calibration is generally adequate group P =0.345, P =0.765, P =0.272 and P =0.062 for STS, Eurosc1, Eurosc2, and IS respectively. The discriminatory power of STS score 0.649 (95% CI 0.529 to 0.770, P =0.012), Eurosc1 0.706 (95% CI 0.589 to 0.823, P ≤0.001), Eurosc2 was 0.704 (95% CI 0.590-0.818 P =0.001) and InsCor 0.739 (95% CI 0.638 to 0.839, P ≤0.001).ConclusionWe can say that overall, the InsCor was the best model, mainly in the discrimination of the sample. The InsCor showed good accuracy, in addition to being effective and easy to apply, especially by using a smaller number of variables compared to the other models.

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“…EuroSCORE II [ 8 ] mortality estimate was 3.48±3.99% and our actual mortality was 8.16%. At a concomitant period, from October 2008 to July 2009, Lisboa et al [ 22 ] demonstrated inadequate calibration of EuroSCORE II at InCOR-FMUSP, and found better calibration of additive and logistic EuroSCORE and InsCor, a locally developed risk model. Indeed, the poorly calibrated EuroSCORE II to predict mortality in the group of patients evaluated reinforces the need for implementation, and widespread use of a Brazilian risk model.…”

Section: Discussionmentioning

confidence: 99%

Late outcome analysis of the Braile Biomédica® pericardial valve in the aortic position

Azeredo¹,

Veronese²,

Santiago³

et al. 2014

Revista Brasileira De Cirurgia Cardiovascular

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ObjectiveAortic valve replacement with Braile bovine pericardial prosthesis has been routinely done at the Heart Institute of the Universidade de São Paulo Medical School since 2006. The objective of this study is to analyze the results of Braile Biomédica® aortic bioprosthesis in patients with aortic valve disease.MethodsWe retrospectively evaluated 196 patients with aortic valve disease submitted to aortic valve replacement with Braile Biomédica® bovine pericardial prosthesis, between 2006 and 2010. Mean age was 59.41±16.34 years and 67.3% were male. Before surgery, 73.4% of patients were in NYHA functional class III or IV.ResultsHospital mortality was 8.16% (16 patients). Linearized rates of mortality, endocarditis, reintervention, and structural dysfunction were 1.065%, 0.91%, 0.68% and 0.075% patients/year, respectively. Actuarial survival was 90.59±2.56% in 88 months. Freedom from reintervention, endocarditis and structural dysfunction was respectively 91.38±2.79%, 89.84±2.92% and 98.57±0.72% in 88 months.ConclusionThe Braile Biomédica® pericardial aortic valve prosthesis demonstrated actuarial survival and durability similar to that described in the literature, but further follow up is required to assess the incidence of prosthetic valve endocarditis and structural dysfunction in the future.

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EuroSCORE II and the importance of a local model, InsCor and the future SP-SCORE

Abstract: Rev Bras Cir Cardiovasc | Braz J Cardiovasc SurgRev Bras Cir Cardiovasc 2014;29(1) power of discrimination. Still, we must not forget that "few variables as possible" prevails in a model in order to have a greater acceptance [12,13]. At the Heart Institute, Clinics

Cited by 24 publications

References 25 publications

Mortality Risk After Cardiac Surgery: Application of Inscor in a University Hospital in Brazil's Northeast

Mortality Risk After Cardiac Surgery: Application of Inscor in a University Hospital in Brazil's Northeast

InsCor and other three international scores performance in cardiac surgery at the Santa Casa de Marilia

Late outcome analysis of the Braile Biomédica® pericardial valve in the aortic position

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