Prognostic Value of Daily Cardiac Surgery Score (CASUS) and its Derivatives in Cardiac Surgery Patients

Badreldin, Akmal M.A.; Kroener, Axel; Heldwein, M.; Doerr, Fabian; Vogt, H.; Ismail, Mohamed; Bossert, Torsten; Hekmat, Khosro

doi:10.1055/s-0030-1250080

Cited by 17 publications

(19 citation statements)

References 17 publications

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“…All the APACHE models are based on the most abnormal values registered during the first 24 h after ICU admission. However, because several studies [13,14] have supported serial daily usage of postoperative risk stratification models, we chose to evaluate APACHE II on all ICU days. In our study, APACHE II had the worst discrimination of the four models studied but its calibration was better than that of SAPS II.…”

Section: Discussionmentioning

confidence: 99%

A comparative study of four intensive care outcome prediction models in cardiac surgery patients

Doerr

Badreldin

Heldwein

et al. 2011

J Cardiothorac Surg

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BackgroundOutcome prediction scoring systems are increasingly used in intensive care medicine, but most were not developed for use in cardiac surgery patients. We compared the performance of four intensive care outcome prediction scoring systems (Acute Physiology and Chronic Health Evaluation II [APACHE II], Simplified Acute Physiology Score II [SAPS II], Sequential Organ Failure Assessment [SOFA], and Cardiac Surgery Score [CASUS]) in patients after open heart surgery.MethodsWe prospectively included all consecutive adult patients who underwent open heart surgery and were admitted to the intensive care unit (ICU) between January 1st 2007 and December 31st 2008. Scores were calculated daily from ICU admission until discharge. The outcome measure was ICU mortality. The performance of the four scores was assessed by calibration and discrimination statistics. Derived variables (Mean- and Max- scores) were also evaluated.ResultsDuring the study period, 2801 patients (29.6% female) were included. Mean age was 66.9 ± 10.7 years and the ICU mortality rate was 5.2%. Calibration tests for SOFA and CASUS were reliable throughout (p-value not < 0.05), but there were significant differences between predicted and observed outcome for SAPS II (days 1, 2, 3 and 5) and APACHE II (days 2 and 3). CASUS, and its mean- and maximum-derivatives, discriminated better between survivors and non-survivors than the other scores throughout the study (area under curve ≥ 0.90). In order of best discrimination, CASUS was followed by SOFA, then SAPS II, and finally APACHE II. SAPS II and APACHE II derivatives had discrimination results that were superior to those of the SOFA derivatives.ConclusionsCASUS and SOFA are reliable ICU mortality risk stratification models for cardiac surgery patients. SAPS II and APACHE II did not perform well in terms of calibration and discrimination statistics.

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Section: Discussionmentioning

confidence: 99%

A comparative study of four intensive care outcome prediction models in cardiac surgery patients

Doerr

Badreldin

Heldwein

et al. 2011

J Cardiothorac Surg

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“…Many of these studies report AUROCs inferior to our 2VSS referent (6,19,20,(23)(24)(25)(26). Diagnosis-specific scoring systems, such as the Cardiac Surgery Score (CASUS), generally have provided superior discriminant accuracy in the specific subsets of patients they were designed to serve (27)(28)(29).…”

Section: Discussionmentioning

confidence: 99%

The explained variance and discriminant accuracy of APACHE IVa severity scoring in specific subgroups of ICU patients

Raschke¹,

Gerkin²,

Ramos³

et al. 2018

Southwest J Pulm Crit Care

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“…The Log-CASUS is a daily mortality score specifically related to patients in extracorporeal circulation during cardiac surgery postoperative care; it is a method of easy stratification and implementation at a patient's bedside [ 3 , 4 ] , which can be done on the internet [ 5 , 6 ] .…”

Section: Introductionmentioning

confidence: 99%

Predictive Factors of Long-Term Stay in the ICU after Cardiac Surgery: Logistic CASUS Score, Serum Bilirubin Dosage and Extracorporeal Circulation Time

Pimentel¹,

Soares²,

Murad³

et al. 2017

Braz J Cardiovasc Surg

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ObjectiveTo test the capacity of the Logistic CASUS Score on the second postoperative day, the total serum bilirubin dosage on the second postoperative day and the extracorporeal circulation time, as possible predictive factors of long-term stay in Intensive Care Unit after cardiac surgery.MethodsEight-two patients submitted to cardiac surgery with extracorporeal circulation were selected. The Logistic CASUS Score on the second postoperative day was calculated and bilirubin dosage on the second postoperative day was measured. The extracorporeal circulation time was also registered. Patients were divided into two groups: Group A, those who were discharged up to the second day of postoperative care; Group B, those who were discharged after the second day of postoperative care.ResultsIn this study, 40 cases were listed in Group A and 42 cases in Group B. The mean extracorporeal circulation time was 83.9±29.4 min in Group A and 95.8±29.31 min in Group B. Extracorporeal circulation time was not significant in this study (P=0.0735). The level of P significance of bilirubin dosage on the second postoperative day was 0.0003 and an area under the ROC curve of 0.708 with a cut-off point at 0.51 mg/dl was registered. The level of P significance of Logistic CASUS Score on the second postoperative day was 0.0001 and an area under the ROC curve of 0.723 with a cut-off point at 0.40% was registered.ConclusionThe Logistic CASUS Score on the second postoperative day has shown to be better than the bilirubin dosage on the second postoperative day as a predictive tool for calculating the length of stay in intensive care unit during the postoperative care period of patients. Notwithstanding, extracorporeal circulation time has failed to prove itself as an efficient tool to predict an extended length of stay in intensive care unit.

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Prognostic Value of Daily Cardiac Surgery Score (CASUS) and its Derivatives in Cardiac Surgery Patients

Abstract: CASUS derivatives including δ CASUS have a good prognostic value for cardiac surgery patients with regard to the prediction of mortality and survival during ICU stay, with the exception of total CASUS which was not informative.

Cited by 17 publications

References 17 publications

A comparative study of four intensive care outcome prediction models in cardiac surgery patients

A comparative study of four intensive care outcome prediction models in cardiac surgery patients

The explained variance and discriminant accuracy of APACHE IVa severity scoring in specific subgroups of ICU patients

Predictive Factors of Long-Term Stay in the ICU after Cardiac Surgery: Logistic CASUS Score, Serum Bilirubin Dosage and Extracorporeal Circulation Time

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