Evaluation of the Society of Thoracic Surgeons score system for isolated coronary bypass graft surgery in a Brazilian population

Abstract

ObjectiveReport the experience with the Society of Thoracic Surgeons scoring system in a Brazilian population submitted to isolated coronary artery bypass graft surgery.MethodsData were collected from January-2010 to December-2011, and analyzed to determine the performance of the Society of Thoracic Surgeons scoring system on the determination of postoperative mortality and morbidity, using the method of the receiver operating characteristic curve as well as the Hosmer-Lemeshow and the Chi-square goodness of fit tests. From the 1083 cardiac surgeries performed during the study period 659 represented coronary artery bypass graft procedures which are included in the present analysis. Mean age was 61.4 years and 77% were men.ResultsGoodness of fit tests have shown good calibration indexes both for mortality (X2=6.78, P=0.56) and general morbidity (X2=6.69, P=0.57). Analysis of area under the ROC-curve (AUC) demonstrated a good performance to detect the risk of death (AUC 0.76; P<0.001), renal failure (AUC 0.79; P<0.001), prolonged ventilation (AUC 0.80; P<0.001), reoperation (AUC 0.76; P<0.001) and major morbidity (AUC 0.75; P<0.001) which represents the combination of the assessed postoperative complications. STS scoring system did not present comparable results for short term hospital stay, prolonged length of hospital stay and could not be properly tested for stroke and wound infection.ConclusionSociety of Thoracic Surgeons scoring system presented a good calibration and discrimination in our population to predict postoperative mortality and the majority of the harmful events following coronary artery bypass graft surgery. Analysis of larger samples might be needed to further validate the use of the score system in Brazilian populations.

A score to estimate 30-day mortality after intensive care admission after cardiac surgery

“…21 In a Brazilian population of 659 patients submitted to isolated CABG surgery, the predictive performance of the STS score for postoperative mortality was 0.76. 22 C-statistics for all those scores are inferior to that of our model (0.857). Similarly, the C-statistic of our model was lowered to 0.823 when rerun using only preoperative variables.…”

Age, Creatinine and Ejection Fraction Score in Brazil: Comparison with InsCor and the EuroSCORE

“…After the publication of the administrative database of the Brazilian Unified Health System [Sistema Único de Saúde (SUS)], showing a mortality in cardiac surgery of 8% in Brazil 20 , efforts were made related to the validation of international risk models 21 and the formulation of national models 22 .…”

Improving postoperative outcomes in a Brazilian hospital through educational programs based on reports of an international database in cardiac surgery

“…From January 2012 to December 2013, 667 CABGs were performed. The predicted risk of in-hospital mortality by the score of the Society of Thoracic Surgeons (validated in the hospital [ 2 ]) was 1.2 % in 2012 and 0.96 % in 2013. As shown in Table 1 , there was a reduction in transfusion comparing 2012 and 2013.…”