Early mortality from off-pump and on-pump coronary bypass surgery in Canada: A comparison of the STS and the EuroSCORE risk prediction algorithms

Farrokhyar, Forough; Wang, Xiaoyin; Kent, Rosanne; Lamy, André

doi:10.1016/s0828-282x(07)70843-7

Cited by 21 publications

(16 citation statements)

References 17 publications

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“…This is in contrast to the findings of some earlier observational studies [7,[16][17][18] but in agreement with others [19][20][21][22]. Our 30-day mortality rates are very similar to those reported in a recent cohort from another Canadian university hospital [23] and by the Multicenter Study of Perioperative Ischemia investigators [20], who also found no association between statin use and in-hospital all-cause mortality (all-cause mortality rate, 1.9% and 2.4% for statin users and nonusers, respectively; crude OR, 0.79; 95% CI, 0.45-1.36). Our results are also consistent with the findings of the only 2 randomized trials of statin use for cardiac surgery patients; these studies demonstrated 30-day mortality rates !2%, with no significant difference between persons who were randomized to receive statin and those randomized to receive placebo [21,24].…”

Section: Discussionsupporting

confidence: 91%

Preoperative Statin Use and Infection after Cardiac Surgery: A Cohort Study

Mohamed¹,

McAlister²,

Pretorius³

et al. 2009

CLIN INFECT DIS

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Preoperative statin use was not associated with a reduction in the rate of postoperative infection among patients who underwent cardiac surgery. This lack of apparent benefit for high-risk patients argues against the routine use of statins as a preoperative strategy for lower-risk patients and supports calls for randomized trials to define whether preoperative statin use influences postoperative rates of infection.

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Section: Discussionsupporting

confidence: 91%

Preoperative Statin Use and Infection after Cardiac Surgery: A Cohort Study

Mohamed¹,

McAlister²,

Pretorius³

et al. 2009

CLIN INFECT DIS

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“…However, in a general sense the predictive performance of the STS algorithm is comparable with the other scoring systems. 21,23 Parsonnet Score…”

Section: Society Of Thoracic Surgeons Scorementioning

confidence: 99%

Risk Stratification Models for Cardiac Surgery

Granton

Cheng

2008

Semin Cardiothorac Vasc Anesth

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A wide variety of risk stratification systems have been developed to quantify the risk of cardiac surgery. Generally, the focus has been on mortality; however, more recently models have been developed that allow the preoperative prediction of the incidence of morbidity, including renal failure, infection, prolonged ventilation, and neurologic deficit. Many of these risk stratification models are developed from large databases of cardiac surgical patients. Patient and surgical factors that are present preoperatively are assessed for their predictive value for postoperative complications. Risk factors that are found to be significant are assigned a specific weight in the overall summation of risk. These models have been used as tools to compare surgeon's results, institutional outcomes, individual patient risk, and within quality improvement programs. This article will focus on the European System for Cardiac Operative Risk Evaluation, the Society of Thoracic Surgeons score, the Parsonnet score, Cleveland Clinic Model, the Bayes model, and the Northern New England Score.

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“…Toumpoulis et al [25] 0.77 0.66 Xu et al [26 ] 0.71 ND Jin et al [27] 0.791 ND Yap et al [28] 0.82 ND Antunes et al [29] 0.754 ND Farrokhyar et al [30 ] 0 development, the Parsonnet classification overestimated mortality predictions by more than 100% in the low and moderate-risk categories (score of 0-14 points) and by more than 250% in the high and very high-risk groups of patients (score greater than 14 points) [22,34,35]. The risk overestimation is particularly obvious in octogenarians who, with a minimum of 20 points, had a predicted mortality of 31% with the original Parsonnet score.…”

Section: Predictive Performance Of Risk Models In Cardiac Surgerymentioning

confidence: 99%