Comparative Study of the Aristotle Comprehensive Complexity and the Risk Adjustment in Congenital Heart Surgery Scores

Bojan, Mirela; Gerelli, Sébastien; Gioanni, Simone; Pouard, Philippe; Vouhé, Pascal

doi:10.1016/j.athoracsur.2011.04.056

Cited by 30 publications

(20 citation statements)

References 16 publications

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“…Although still based on subjective probability, the Aristotle score is increasingly used in risk estimates and resource planning [5, 23]. In this analysis it was the main factor independently predictive of postoperative LOS along with CPB time.…”

Section: Commentmentioning

confidence: 93%

Morbidity of the Arterial Switch Operation

Stoica

Carpenter

Campbell

et al. 2012

The Annals of Thoracic Surgery

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Background The arterial switch operation (ASO) has become a safe, reproducible surgical procedure with low mortality in experienced centers. We examined morbidity, which remains significant, particularly for complex ASO. Methods From 2003 to 2011, 101 consecutive patients underwent ASO, arbitrarily classified as “simple” (n = 52) or “complex” (n = 49). Morbidity was measured in selected complications and postoperative hospitalization. Three outcomes were analyzed: ventilation time, postextubation hospital length of stay, and a composite morbidity index, defined as ventilation time + postextubation hospital length of stay + occurrence of selected major complications. Complexity was measured with the comprehensive Aristotle score. Results The operative mortality was zero. Twenty-five major complications occurred in 23 patients: 6 of 25 (12%) in simple ASO and 19 of 49 (39%) in complex ASO (p = 0.002). The most frequent complication was unplanned reoperation (15 vs 6, p = 0.03). No patients required permanent pacing. The complex group had a significantly higher morbidity index and longer ventilation time and postextubation hospital length of stay. In multivariate analysis, factors independently predicting higher morbidity were the comprehensive Aristotle score, arch repair, bypass time, and malaligned commissures. Myocardial infarction caused one sudden late death at 3 months. Late coronary failure was 2%. Overall survival was 99% at a mean follow-up of 49 ± 27 months. Conclusions In this consecutive series without operative mortality, morbidity was significantly higher in complex ASO. The only anatomic incremental risk factors for morbidity were aortic arch repair and malaligned commissures, but not primary diagnosis, weight less than 2.5 kg, or coronary patterns.

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Section: Commentmentioning

confidence: 93%

Morbidity of the Arterial Switch Operation

Stoica

Carpenter

Campbell

et al. 2012

The Annals of Thoracic Surgery

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“…The results of the study were evaluated, it was seen that RACHS, ABS and ACS systems were successful in determining mortality in congenital heart diseases in a parallel way to the previous studies regarding these systems 4,5,10,11 .…”

Section: Discussionmentioning

confidence: 87%

Comparison of risk scoring systems in congenital heart surgery

et al. 2016

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Hacettepe University Faculty of Medicine Department of Cardiovascular Surgery; data of 413 patients under 18 years old who had congenital heart surgery were evaluated between 01.01.2011-30.10.2012 and risk scorings were made by "RACHS-1 (Risk Adjustment in Congenital Heart Surgery)", "Aristotle Basic Complexity Score (ABS)" and "Aristotle Comprehensive Complexity Score (ACS)" systems used in evaluation of the risk of mortality and morbidity in (ACS)" systems used in evaluation of the risk of mortality and morbidity in congenital heart surgery. Data obtained were compared by Mann-Whitney U test and how effective these systems were in evaluating mortality and morbidity and their superiorities over each other were examined. Following the research, it was observed that all three systems were effective in evaluating mortality and morbidity; the most successful of them in foreseeing the event was the ACS system, ACS system was followed by RACHS-1 system and ABS system was the most incapable of these in foreseeing the event. It was seen that in detecting time related mortality, rating of these tests changed, RACHS-1 system detected the time related mortality best. It was also seen that with RACHS-1 system, a previously evaluated concept, it was possible to determine morbidity.

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“…The RACHS score has been shown to be a more powerful predictor of overall mortality9; however, the comprehensive Aristotle score, which also takes into account key variables such as birth weight, prematurity, and major extra-cardiac abnormalities, has been shown to be a superior predictor of 30 day postoperative mortality 10…”

Section: Methodsmentioning

confidence: 99%