Influence of pre- and intraoperative factors on hospital mortality after elective cardiac surgery with cardiopulmonary bypass. A retrospective study
#2021-2
PDF_2021-2_128-135 (Русский)
HTML_2021-2_128-135 (Русский)

Keywords

cardiac surgical procedures
cardiopulmonary bypass
nomograms
mortality

How to Cite

Berikashvili LB, Kuzovlev AN, Yadgarov MY, Ovezov AM, Ryabova EV, Kadantseva KK, Perekhodov SN, Likhvantsev VV Influence of pre- and intraoperative factors on hospital mortality after elective cardiac surgery with cardiopulmonary bypass. A retrospective study. Annals of Critical Care. 2021;(2):128–135. doi:10.21320/1818-474X-2021-2-128-135.

Statistic

Abstract Views: 5
PDF_2021-2_128-135 (Русский) Downloads: 0
HTML_2021-2_128-135 (Русский) Downloads: 2
Plum Analytics

Language

English Русский

Social Networks

Keywords

Up

Abstract

Introduction. The Vasoactive-Inotropic Score has been shown as a good predictor of adverse events in postoperative period. Nevertheless, the score is not included in modern predictive models.

Objectives. To modify the nomogram that was created as a result of the E-CABG registry trial, and to evaluate the efficacy of the modification to predict 30-day mortality after elective cardiac surgery with cardiopulmonary bypass.

Materials and methods. Pre- and intraoperative data of 158 patients who underwent elective cardiac surgery with cardiopulmonary bypass was analyzed. Based on the obtained results, the SYNTAX value in the original nomogram was replaced with the VIS value. The predictive model was evaluated in ROC-analysis.

Results. The frequency of 30-day mortality in group was 5,06 %. According to the results of ROC-analysis the modified nomogram has AUC = 0,897 (0.844– 0.951) (p < 0.001). The cut-off value was 12.75 points (sensitivity — 87.5 %; specificity — 86.7 %).

Conclusions. The modified nomogram has an excellent predictive ability for 30-day mortality.

https://doi.org/10.21320/1818-474X-2021-2-128-135
PDF_2021-2_128-135 (Русский)
HTML_2021-2_128-135 (Русский)

References

  1. Vogenberg F.R. Predictive and prognostic models: implications for healthcare decision-making in a modern recession. Am Health Drug Benefits. 2009; 2(6): 218–22.
  2. Van Calster B., McLernon D.J., van Smeden M., et al.; Topic Group ‘Evaluating diagnostic tests and prediction models’ of the STRATOS initiative. Calibration: the Achilles heel of predictive analytics. BMC Med. 2019; 17(1): 230. Published 2019 Dec 16. DOI: 10.1186/s12916-019-1466-7.
  3. Dominici C., Salsano A., Nenna A., et al. A Nomogram for Predicting Long Length of Stay in The Intensive Care Unit in Patients Undergoing CABG: Results From the Multicenter E-CABG Registry. J Cardiothorac Vasc Anesth. 2020; 34(11): 2951–61. DOI: 10.1053/j.jvca.2020.06.015.
  4. Biancari F., Ruggieri V.G., Perrotti A., et al. European Multicenter Study on Coronary Artery Bypass Grafting (E-CABG registry): Study Protocol for a Prospective Clinical Registry and Proposal of Classification of Postoperative Complications. J Cardiothorac Surg. 2015; 10: 90. Published 2015 Jun 30. DOI: 10.1186/s13019-015-0292-z.
  5. Yamazaki Y., Oba K., Matsui Y., Morimoto Y. Vasoactive-inotropic score as a predictor of morbidity and mortality in adults after cardiac surgery with cardiopulmonary bypass. J Anesth. 2018; 32(2): 167–73. DOI: 10.1007/s00540-018-2447-2.
  6. Dyke C., Aronson S., Dietrich W., et al. Universal definition of perioperative bleeding in adult cardiac surgery. J Thorac Cardiovasc Surg. 2014; 147(5): 1458–63.e1. DOI: 10.1016/j.jtcvs.2013.10.070.
  7. Lasocki S., Provenchère S., Bénessiano J., et al. Cardiac troponin I is an independent predictor of in-hospital death after adult cardiac surgery. Anesthesiology. 2002; 97(2): 405–11. DOI: 10.1097/00000542-200208000-00018.
  8. Lurati Buse G.A., Koller M.T., Grapow M., et al. The prognostic value of troponin release after adult cardiac surgery — a meta-analysis. Eur J Cardiothorac Surg. 2010; 37(2): 399–406. DOI: 10.1016/j.ejcts.2009.05.054.
  9. Croal B.L., Hillis G.S., Gibson P.H., et al. Relationship between postoperative cardiac troponin I levels and outcome of cardiac surgery. Circulation. 2006; 114(14): 1468–75. DOI: 10.1161/CIRCULATIONAHA.105.602370.
  10. Overgaard C.B., Dzavík V. Inotropes and vasopressors: review of physiology and clinical use in cardiovascular disease. Circulation. 2008; 118(10): 1047–56. DOI: 10.1161/CIRCULATIONAHA.107.728840.
  11. Belletti A., Lerose C.C., Zangrillo A., Landoni G. Vasoactive-Inotropic Score: Evolution, Clinical Utility, and Pitfalls [published online ahead of print, 2020 Sep 22]. J Cardiothorac Vasc Anesth. 2020; S1053-0770(20)31035-1. DOI: 10.1053/j.jvca.2020.09.117.
  12. Koponen T., Karttunen J., Musialowicz T., et al. Vasoactive-inotropic score and the prediction of morbidity and mortality after cardiac surgery. Br J Anaesth. 2019; 122(4): 428–36. DOI: 10.1016/j.bja.2018.12.019.
  13. Nashef S.A., Roques F., Sharples L.D., et al. EuroSCORE II. Eur J Cardiothorac Surg. 2012; 41(4): 734–45. DOI: 10.1093/ejcts/ezs043.
  14. Association NYH, Fox A.C., Gorlin R., Levin R.I., New York Heart Association. Criteria Committee. Nomenclature and criteria for diagnosis of diseases of the heart and great vessels. 9th ed. Boston, MA: Lippincott Williams and Wilkins, 1994.
  15. The Free Dictionary [Internet]. “30-day mortality”. Segenʼs Medical Dictionary, Farlex, Inc., 2011 [cited 15 Apr. 2021]. Available from: https://medical-dictionary.thefreedictionary.com/30-day+mortality.
  16. Granton J., Cheng D. Risk stratification models for cardiac surgery. Semin Cardiothorac Vasc Anesth. 2008; 12(3): 167–74. DOI: 10.1177/1089253208323681.
  17. Sullivan P.G., Wallach J.D., Ioannidis J.P. Meta-Analysis Comparing Established Risk Prediction Models (EuroSCORE II, STS Score, and ACEF Score) for Perioperative Mortality During Cardiac Surgery. Am J Cardiol. 2016; 118(10): 1574–82. DOI: 10.1016/j.amjcard.2016.08.024.
  18. Mandrekar J.N. Receiver operating characteristic curve in diagnostic test assessment. J Thorac Oncol. 2010; 5(9): 1315–16. DOI: 10.1097/JTO.0b013e3181ec173d.
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Copyright (c) 2021 ANNALS OF CRITICAL CARE

Downloads

Download data is not yet available.