Validation and quality measurements for STS, EuroSCORE II and a regional risk model in Brazilian patients

Mejía, Omar Asdrúbal Vilca; Borgomoni, Gabrielle Barbosa; Zubelli, Jorge P.; Dallan, Luís Roberto Palma; Pomerantzeff, Pablo Maria Alberto; Oliveira, Marco; Petrucci, Orlando; Tiveron, Marcos Gradim; Nakazone, Marcelo Arruda; Tineli, Rafael Angelo; Campagnucci, Valquíria Pelisser; Silva, Roberto Rocha E; Rodrigues, Alfredo José; Gomes, Walter J.; Lisboa, Luiz Augusto Ferreira; Jatene, Fábio Biscegli

doi:10.1371/journal.pone.0238737

Cited by 11 publications

(13 citation statements)

References 24 publications

(30 reference statements)

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“…Compared to low weight or small for gestational age, the severity of lesions, and the complexity of surgical procedures were more widely accepted as significant predictors of early mortality after cardiac surgery in neonates. We found that clinical outcomes in this report were similar to those identified by the Society of Thoracic Surgeons in that the in-hospital mortality increased with higher STAT categories and Category 5 was associated with the highest risk ( 11 – 14 , 23 ). Additionally, a longer aortic cross-clamp time was considered an important risk factor for in-hospital mortality.…”

Section: Discussionsupporting

confidence: 82%

Association Between Preoperative Factors and In-hospital Mortality in Neonates After Cardiac Surgery in China

Zhu

Qiu

et al. 2021

Front. Pediatr.

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Background: Little is known about preoperative factors affecting cardiac surgery outcomes of neonates in China. We sought to examine the association between characteristics of neonates with congenital heart disease (CHD) and early postoperative outcomes after cardiac repair in a tertiary care paediatric hospital.Methods: A single-centre retrospective cohort study of neonates who underwent cardiac surgery between January 2006 and December 2019 was performed. Demographic, institutional, and surgical characteristics of neonates were examined and their association with in-hospital mortality was analysed using multivariable logistic regression models.Results: During the study period, we analysed the outcomes of 1,078 neonates. In-hospital mortality decreased to 13.8% in the era 2017–2019. The overall in-hospital mortality rate was 16.3%. Normal weight at surgery [odds ratio (OR), 0.63; 95% confidence interval (CI), 0.47–0.85; P = 0.003] was associated with lower mortality risk. Poor health status (emergent: OR, 3.11; 95% CI, 1.96–4.94; P < 0.001; elective: OR, 1.63; 95% CI, 1.11–2.40; P = 0.013), higher Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STAT) categories (STAT 5 category: OR, 2.58; 95% CI, 1.04–6.43; P = 0.042), and limited individual surgeon experience (surgeon with 5–10 operations per year: OR, 1.43; 95% CI, 1.06–1.95; P = 0.021) were associated with higher odds of early death.Conclusion: In-hospital mortality after neonatal cardiac surgery remained high in our centre over the past 10 years. Some preoperative aspects, including low-weight at surgery, poor health status, increased surgical complexity, and limited surgeon experience were significantly associated with higher mortality. Based on the observed associations, the necessary practises to be modified, especially in preoperative care, should be identified and assessed in future research.

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Section: Discussionsupporting

confidence: 82%

Association Between Preoperative Factors and In-hospital Mortality in Neonates After Cardiac Surgery in China

Zhu

Qiu

et al. 2021

Front. Pediatr.

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“…This result was in contradiction with what has been observed, during the same period, when applying these two scores in developed countries [ 14 ]. Furthermore, in a more recent cohort of 5,222 Brazilian patients, including 60% of patients who benefited from a CABG, the regional score outperformed the STS-PROM and the EuroSCORE II, which also greatly underestimated the observed mortality [ 15 ]. The calibration curves of the Euro-SCORE II and STS-PROM of this Brazilian cohort are in perfect adequacy with those generated by our study.…”

Section: Discussionmentioning

confidence: 99%

“…Since international scores are not applicable in all countries, some national scores have emerged, and were validated on their respective populations, such as the Chinese [ 12 ], or the Australian System for Cardiac Operative Risk Evaluation [ 21 ] or the São Paulo risk Score for Brazil [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Applicability of the Most Commonly Used Risk Scores for Patients Undergoing Isolated Coronary Artery Bypass Grafting in Algeria

BOUKHMIS¹,

NOUAR²,

Guerchani³

2022

Journal of the Saudi Heart Association

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Objectives The applicability of European system for cardiac operative risk evaluation II (EuroSCORE II) and the Society of Thoracic Surgeons Predicted Risk Of Mortality (STS-PROM) as well as the initial logistic Parsonnet risk score, who have been developed from European and American datasets, is questionable outside these regions. We aimed to assess the performance of these three risk scores for patients undergoing isolated coronary artery bypass grafting (CABG) in Algeria. Methods Between June 2014 and June 2016, data from 235 consecutive patients, who underwent isolated CABG at a reference center in Algiers, were prospectively collected and scored according to the EuroSCORE II, STS-PROM and the Parsonnet score. Their discriminative power was evaluated by the area under the receiver operating characteristic curve (AUC) while their calibration was tested by the Hosmer–Lemeshow goodness-of-fit test. Results The mean patient age was 59.08 years and 18.3% were female. The mortality at 30 days was 3.40%. The mortality expected by EuroSCORE II, STS-PROM and by Parsonnet risk score was: 1.33%, 0.78% and 3.35%, respectively. Discriminatory ability was fair for the Parsonnet risk score, good for the STS PROM and excellent for EuroSCORE II (AUCs = 0.737, 0.788, and 0.892, respectively). Regarding calibration, EuroSCORE II and STS-PROM under estimated observed mortality (Hosmer–Lemeshow test: P< 0.001 for both scores), while the Parsonnet risk score was well calibrated (Hosmer–Lemeshow test: p = 0.395). Conclusions EuroSCORE II and STS-PROM had excellent and good discriminating power, respectively, but both underestimated the risk of 30 days mortality following isolated CABG at a reference center in Algiers. The Parsonnet risk score was well calibrated but was moderately discriminating. The development of a local risk score or the recalibration of recent international risk scores is necessary.

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“…No estado de São Paulo temos o SPScore, um índice de risco criado com inteligência artificial e que poderia ajudar para um ressarcimento mais apropriado perante as fontes pagadoras, no nosso cenário. 24 Podemos dizer que no Brasil, para acompanhar estas mudanças, existe no Departamento de Cardiopneumologia da Faculdade de Medicina da Universidade de São Paulo uma linha de pesquisa que começou em 2012 com o objetivo de estratificar e melhorar resultados em pacientes encaminhados para cirurgia cardiovascular. Alunos de graduação e pósgraduação pesquisam e publicam temas sobre implementação de grandes bancos de dados, construção de escores de risco utilizando inteligência artificial, identificação de estratégias custo-efetivas em grupos de risco e otimização de processos, entre outras.…”

Section: Lily Tomlinunclassified

Do Volume para a Geração de Valor em Cirurgia Cardíaca: O que Falta para Dar a Largada no Brasil?

Mejía¹,

Jatene²

2023

Arquivos Brasileiros De Cardiologia

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Validation and quality measurements for STS, EuroSCORE II and a regional risk model in Brazilian patients

Cited by 11 publications

References 24 publications

Association Between Preoperative Factors and In-hospital Mortality in Neonates After Cardiac Surgery in China

Association Between Preoperative Factors and In-hospital Mortality in Neonates After Cardiac Surgery in China

Applicability of the Most Commonly Used Risk Scores for Patients Undergoing Isolated Coronary Artery Bypass Grafting in Algeria

Do Volume para a Geração de Valor em Cirurgia Cardíaca: O que Falta para Dar a Largada no Brasil?

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