Universität zu Köln

Doerr, Fabian, Heldwein, Matthias B., Bayer, Ole, Sabashnikov, Anton ORCID: 0000-0002-6289-1035, Weymann, Alexander, Dohmen, Pascal M., Wahlers, Thorsten and Hekmat, Khosro (2015). Combination of European System for Cardiac Operative Risk Evaluation (EuroSCORE) and Cardiac Surgery Score (CASUS) to Improve Outcome Prediction in Cardiac Surgery. Med. Sci. Monit. Basic Res., 21. S. 172 - 179. SMITHTOWN: INT SCIENTIFIC LITERATURE, INC. ISSN 2325-4394

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Abstract

Background: We hypothesized that the combination of a preoperative and a postoperative scoring system would improve the accuracy of mortality prediction and therefore combined the preoperative ` additive EuroSCORE` (European system for cardiac operative risk evaluation) with the postoperative 'additive CASUS' (Cardiac Surgery Score) to form the 'modified CASUS'. Material/Methods: We included all consecutive adult patients after cardiac surgery during January 2007 and December 2010 in our prospective study. Our single-centre study was conducted in a German general referral university hospital. The original additive and the 'modified CASUS' were tested using calibration and discrimination statistics. We compared the area under the curve (AUC) of the receiver characteristic curves (ROC) by DeLong's method and calculated overall correct classification (OCC) values. Results: The mean age among the total of 5207 patients was 67.2 +/- 10.9 years. Whilst the ICU mortality was 5.9% we observed a mean length of ICU stay of 4.6 +/- 7.0 days. Both models demonstrated excellent discriminatory power (mean AUC of 'modified CASUS': 3 0.929; 'additive CASUS': 3 0.920), with no significant differences according to DeLong. Neither model showed a significant p-value (<0.05) in calibration. We detected the best OCC during the 2nd day (modified: 96.5%; original: 96.6%). Conclusions: Our 'additive' and 'modified' CASUS are reasonable overall predictors. We could not detect any improvement in the accuracy of mortality prediction in cardiac surgery by combining a preoperative and a postoperative scoring system. A separate calculation of the two individual elements is therefore recommended.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Doerr, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Heldwein, Matthias B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bayer, Ole UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabashnikov, Anton UNSPECIFIED orcid.org/0000-0002-6289-1035 UNSPECIFIED Weymann, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Dohmen, Pascal M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Hekmat, Khosro UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-419407
DOI:	10.12659/MSMBR.895004
Journal or Publication Title:	Med. Sci. Monit. Basic Res.
Volume:	21
Page Range:	S. 172 - 179
Date:	2015
Publisher:	INT SCIENTIFIC LITERATURE, INC
Place of Publication:	SMITHTOWN
ISSN:	2325-4394
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INTENSIVE-CARE-UNIT; SURGICAL-PATIENTS; MORTALITY; VALIDATION; MODELS; MULTICENTER; PERFORMANCE; PARSONNET; SURVIVAL; SOCIETY Multiple languages Medicine, Research & Experimental Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/41940