Mortality risk prediction in high-risk patients undergoing coronary artery bypass grafting: Are traditional risk scores accurate?
<h4>Background</h4>The performance of traditional scores is significantly limited to predict mortality in high-risk cardiac surgery. The aim of this study was to compare the performance of STS, ESII and HiriSCORE models in predicting mortality in high-risk patients undergoing CABG.<h4...
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oai:doaj.org-article:f3d8de5a00f644bda86d7415905a461d2021-12-02T20:15:17ZMortality risk prediction in high-risk patients undergoing coronary artery bypass grafting: Are traditional risk scores accurate?1932-620310.1371/journal.pone.0255662https://doaj.org/article/f3d8de5a00f644bda86d7415905a461d2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255662https://doaj.org/toc/1932-6203<h4>Background</h4>The performance of traditional scores is significantly limited to predict mortality in high-risk cardiac surgery. The aim of this study was to compare the performance of STS, ESII and HiriSCORE models in predicting mortality in high-risk patients undergoing CABG.<h4>Methods</h4>Cross-sectional analysis in the international prospective database of high-risk patients: HiriSCORE project. We evaluated 248 patients with STS or ESII (5-10%) undergoing CABG in 8 hospitals in Brazil and China. The main outcome was mortality, defined as all deaths occurred during the hospitalization in which the operation was performed, even after 30 days. Five variables were selected as predictors of mortality in this cohort of patients. The model's performance was evaluated through the calibration-in-the-large and the receiver operating curve (ROC) tests.<h4>Results</h4>The mean age was 69.90±9.45, with 52.02% being female, 25% of the patients were on New York Heart Association (NYHA) class IV and 49.6% had Canadian Cardiovascular Society (CCS) class 4 angina, and 85.5% had urgency or emergency status. The mortality observed in the sample was 13.31%. The HiriSCORE model showed better calibration (15.0%) compared to ESII (6.6%) and the STS model (2.0%). In the ROC curve, the HiriSCORE model showed better accuracy (ROC = 0.74) than the traditional models STS (ROC = 0.67) and ESII (ROC = 0.50).<h4>Conclusion</h4>Traditional models were inadequate to predict mortality of high-risk patients undergoing CABG. However, the HiriSCORE model was simple and accurate to predict mortality in high-risk patients.Maxim GoncharovOmar Asdrúbal Vilca MejiaCamila Perez de Souza ArthurBianca Maria Maglia OrlandiAlexandre SousaMarco Antônio Praça OliveiraFernando Antibas AtikRodrigo Coelho SegaloteMarcos Gradim TiveronPedro Gabriel Melo de Barros E SilvaMarcelo Arruda NakazoneLuiz Augusto Ferreira LisboaLuís Alberto Oliveira DallanZhe ZhengShengshou HuFabio Biscegli JatenePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0255662 (2021) |
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Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Maxim Goncharov Omar Asdrúbal Vilca Mejia Camila Perez de Souza Arthur Bianca Maria Maglia Orlandi Alexandre Sousa Marco Antônio Praça Oliveira Fernando Antibas Atik Rodrigo Coelho Segalote Marcos Gradim Tiveron Pedro Gabriel Melo de Barros E Silva Marcelo Arruda Nakazone Luiz Augusto Ferreira Lisboa Luís Alberto Oliveira Dallan Zhe Zheng Shengshou Hu Fabio Biscegli Jatene Mortality risk prediction in high-risk patients undergoing coronary artery bypass grafting: Are traditional risk scores accurate? |
| description |
<h4>Background</h4>The performance of traditional scores is significantly limited to predict mortality in high-risk cardiac surgery. The aim of this study was to compare the performance of STS, ESII and HiriSCORE models in predicting mortality in high-risk patients undergoing CABG.<h4>Methods</h4>Cross-sectional analysis in the international prospective database of high-risk patients: HiriSCORE project. We evaluated 248 patients with STS or ESII (5-10%) undergoing CABG in 8 hospitals in Brazil and China. The main outcome was mortality, defined as all deaths occurred during the hospitalization in which the operation was performed, even after 30 days. Five variables were selected as predictors of mortality in this cohort of patients. The model's performance was evaluated through the calibration-in-the-large and the receiver operating curve (ROC) tests.<h4>Results</h4>The mean age was 69.90±9.45, with 52.02% being female, 25% of the patients were on New York Heart Association (NYHA) class IV and 49.6% had Canadian Cardiovascular Society (CCS) class 4 angina, and 85.5% had urgency or emergency status. The mortality observed in the sample was 13.31%. The HiriSCORE model showed better calibration (15.0%) compared to ESII (6.6%) and the STS model (2.0%). In the ROC curve, the HiriSCORE model showed better accuracy (ROC = 0.74) than the traditional models STS (ROC = 0.67) and ESII (ROC = 0.50).<h4>Conclusion</h4>Traditional models were inadequate to predict mortality of high-risk patients undergoing CABG. However, the HiriSCORE model was simple and accurate to predict mortality in high-risk patients. |
| format |
article |
| author |
Maxim Goncharov Omar Asdrúbal Vilca Mejia Camila Perez de Souza Arthur Bianca Maria Maglia Orlandi Alexandre Sousa Marco Antônio Praça Oliveira Fernando Antibas Atik Rodrigo Coelho Segalote Marcos Gradim Tiveron Pedro Gabriel Melo de Barros E Silva Marcelo Arruda Nakazone Luiz Augusto Ferreira Lisboa Luís Alberto Oliveira Dallan Zhe Zheng Shengshou Hu Fabio Biscegli Jatene |
| author_facet |
Maxim Goncharov Omar Asdrúbal Vilca Mejia Camila Perez de Souza Arthur Bianca Maria Maglia Orlandi Alexandre Sousa Marco Antônio Praça Oliveira Fernando Antibas Atik Rodrigo Coelho Segalote Marcos Gradim Tiveron Pedro Gabriel Melo de Barros E Silva Marcelo Arruda Nakazone Luiz Augusto Ferreira Lisboa Luís Alberto Oliveira Dallan Zhe Zheng Shengshou Hu Fabio Biscegli Jatene |
| author_sort |
Maxim Goncharov |
| title |
Mortality risk prediction in high-risk patients undergoing coronary artery bypass grafting: Are traditional risk scores accurate? |
| title_short |
Mortality risk prediction in high-risk patients undergoing coronary artery bypass grafting: Are traditional risk scores accurate? |
| title_full |
Mortality risk prediction in high-risk patients undergoing coronary artery bypass grafting: Are traditional risk scores accurate? |
| title_fullStr |
Mortality risk prediction in high-risk patients undergoing coronary artery bypass grafting: Are traditional risk scores accurate? |
| title_full_unstemmed |
Mortality risk prediction in high-risk patients undergoing coronary artery bypass grafting: Are traditional risk scores accurate? |
| title_sort |
mortality risk prediction in high-risk patients undergoing coronary artery bypass grafting: are traditional risk scores accurate? |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/f3d8de5a00f644bda86d7415905a461d |
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