Does Preoperative B-Type Natriuretic Peptide Better Predict Adverse Outcome and Prolonged Length of Stay Than the Standard European System for Cardiac Operative Risk Evaluation After Cardiac Surgery?

2011 ◽  
Vol 25 (2) ◽  
pp. 256-262 ◽  
Author(s):  
Jean-Luc Fellahi ◽  
Georges Daccache ◽  
David Rubes ◽  
Massimo Massetti ◽  
Jean-Louis Gérard ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Length Of Stay ◽  
Natriuretic Peptide ◽  
Risk Evaluation ◽  
Adverse Outcome ◽  
Operative Risk ◽  
Prolonged Length ◽  
European System ◽  
Cardiac Operative Risk Evaluation

scholarly journals Locally derived system for cardiac operative risk evaluation

2014 ◽  
Vol 67 (11-12) ◽  
pp. 367-371
Author(s):  
Bogoljub Mihajlovic ◽  
Bojan Mihajlovic ◽  
Milica Panic ◽  
Milana Jarakovic ◽  
Snezana Bjelica ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Risk Evaluation ◽  
Operative Risk ◽  
Local Model ◽  
Combined Surgery ◽  
European Model ◽  
Valvular Surgery ◽  
European System ◽  
Local Risk ◽  
Cardiac Operative Risk Evaluation

Introduction. During the last two decades, many authors have found that European Systems for Cardiac Operative Risk Evaluation (additive and logistic models) overestimate the risk in cardiac surgery. The new European model has recently been introduced as an update to previous versions. The aim of the study was to investigate the significance of locally derived system for cardiac operative risk evaluation and to compare its predictive power with the existing European systems. Material and Methods. For developing a local risk prediction model, data from 2681 patients submitted to cardiac surgery at the Institute of Cardiovascular Diseases Vojvodina have thoroughly been collected. Logistic regression analysis was used to construct a local model for prediction of outcome. The evaluation of the local model and three European systems was performed by comparing the observed and expected hospital mortality. Results. The difference between the predicted and observed mortality regardless of the type of surgery was statistically insignificant for the additive European system (p=0.073) and the local model (p=0.134). The logistic European system overestimated the operative risk, while the new European model underestimated mortality. In coronary surgery, all models, except the logistic European system, performed well. In valvular surgery, the new European model and the local model underestimated mortality significantly, while the additive and logistic European models performed well. In combined surgery, the new European system significantly underestimated mortality (p=0.029), while the local model performed well (p=0.252). Conclusion. The locally derived model shows satisfactory results, with good calibration and discriminative power. The local model specifically outperforms all other European systems in terms of discriminatory power in combined surgery subset.

12-Month Outcome After Cardiac Surgery: Prediction by Troponin T in Combination With the European System for Cardiac Operative Risk Evaluation

2009 ◽  
Vol 88 (6) ◽  
pp. 1806-1812 ◽  
Author(s):  
Giovanna A. Lurati Buse ◽  
Michael T. Koller ◽  
Martin Grapow ◽  
Céline M. Brüni ◽  
Jorge Kasper ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Risk Evaluation ◽  
Troponin T ◽  
Operative Risk ◽  
European System ◽  
Cardiac Operative Risk Evaluation

scholarly journals Correlation between EuroSCORE and intensive care unit length of stay after coronary surgery

2011 ◽  
Vol 64 (1-2) ◽  
pp. 46-50
Author(s):  
Bogoljub Mihajlovic ◽  
Svetozar Nicin ◽  
Stamenko Susak ◽  
Miodrag Golubovic ◽  
Lazar Velicki ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Risk Evaluation ◽  
Myocardial Revascularization ◽  
Operative Risk ◽  
Positive Correlation ◽  
Group I ◽  
European System ◽  
Cardiac Operative Risk Evaluation

During the last several years many authors have found that the European System for Cardiac Operative Risk Evaluation is useful in the prediction of not only postoperative mortality but also of the length of stay in the intensive care unit, complication rate and overall treatment expenses. This study included 329 patients who had undergone isolated surgical myocardial revascularization at our Department during the period from January 1st to June 6th, 2008. For the operative risk evaluation, the additive European System for Cardiac Operative Risk Evaluaion was used. In group I (low risk 0-2%) there were 144 patients (43.7%), whereas group II (medium risk 3-5%) and group III (high risk ? 6%) included 141 (42.8%) and 44 (13.4%) patients, respectively. The length of stay in the intensive care unit was 25.56, 32.43 and 49.59 hours for groups I, II and III, respectively. The difference in the mean length of stay in the intensive care unit between the groups was highly statistically significant (p<0.001) with a positive correlation (R=0.193; p<0.001). There is a positive correlation in patients who had undergone surgical myocardial revascularization in terms of operative risk expressed by the additive European System for Cardiac Operative Risk Evaluation and length of stay in the intensive care unit, total intubation period and development of early postoperative complications.

Presepsin (sCD14-ST) Is a Novel Marker for Risk Stratification in Cardiac Surgery Patients

2017 ◽  
Vol 126 (4) ◽  
pp. 631-642 ◽  
Author(s):  
Hagen Bomberg ◽  
Matthias Klingele ◽  
Stefan Wagenpfeil ◽  
Eberhard Spanuth ◽  
Thomas Volk ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Risk Stratification ◽  
Natriuretic Peptide ◽  
Risk Evaluation ◽  
Postoperative Mortality ◽  
Interquartile Range ◽  
Elective Cardiac Surgery ◽  
C Statistic ◽  
European System ◽  
Cardiac Operative Risk Evaluation

Abstract Background Presepsin (soluble cluster-of-differentiation 14 subtype [sCD14-ST]) is a humoral risk stratification marker for systemic inflammatory response syndrome and sepsis. It remains unknown whether presepsin can be used to stratify risk in elective cardiac surgery. The authors therefore determined the usefulness of presepsin for risk stratification in patients having elective cardiac surgery. Methods Eight hundred fifty-six cardiac surgical patients were prospectively studied. Preoperative plasma concentrations of presepsin, procalcitonin, N-terminal pro–hormone natriuretic peptide, cystatin C, and the additive European System of Cardiac Operative Risk Evaluation 2 were compared to mortality at 30 days (primary outcome), 6 months, and 2 yr. Discrimination was assessed with C statistic. Logistic regression analysis was used to calculate univariable and multivariable odds ratios. Results Thirty-day mortality was 3.2%, 6-month mortality was 6.1%, and 2-yr mortality was 10.4% across the population. Median preoperative presepsin concentrations were significantly greater in 30-day nonsurvivors than in survivors: 842 pg/ml (interquartile range, 306 to 1,246) versus 160 pg/ml (interquartile range, 122 to 234); difference, 167 pg/ml (interquartile range, 92 to 301; P &lt; 0.001). The results were similar for 6-month and 2-yr mortality. Compared to the European System of Cardiac Operative Risk Evaluation 2, presepsin concentration provided better discrimination for postoperative mortality at all follow-up periods, including 30 days (C statistic 0.88 vs. 0.74), 6 months (0.87 vs. 0.76), and 2 yr (0.81 vs. 0.74). Presepsin also provided better discrimination than cystatin C, N-terminal pro–hormone natriuretic peptide, or procalcitonin. Elevated presepsin remained an independent risk predictor after adjustment for potential confounding factors. Conclusions Elevated preoperative plasma presepsin concentration is an independent predictor of postoperative mortality in elective cardiac surgery patients and is a stronger predictor than several other commonly used assessments.

scholarly journals Vojvodinascore - local system for cardiac operative risk evaluation

2013 ◽  
Vol 66 (3-4) ◽  
pp. 139-144
Author(s):  
Bogoljub Mihajlovic ◽  
Jadranka Dejanovic ◽  
Bojan Mihajlovic ◽  
Dusan Popovic ◽  
Milica Panic ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Sensitivity And Specificity ◽  
Risk Evaluation ◽  
Cardiac Surgical Procedures ◽  
Local System ◽  
Operative Risk ◽  
Actual State ◽  
European System ◽  
The Difference ◽  
Cardiac Operative Risk Evaluation

Introduction. The aim of the study was to investigate the prognostic value, sensitivity and specificity of both the logistic and additive European System for Cardiac Operative Risk Evaluation (as well as the European System for Cardiac Operative Risk Evaluation II and to assess the necessity for developing a local outcome prediction model in cardiac surgery. Material and Methods. The research included 406 consecutive patients who had undergone cardiac surgical procedures at Institute of Cardiovascular Diseases of Vojvodina from January 2012 to July 2012. The authors compared the predicted mortality according to the additive and logistic European Systems for Cardiac Operative Risk Evaluation, the new European System for Cardiac Operative Risk Evaluation II and the observed mortality (30 days after surgery). Results. The difference between the predicted and observed mortality regarding the whole group of 406 operated cardiac patients was not statistically significant for the additive European System for Cardiac Operative Risk Evaluation (p=0.081) and the European System for Cardiac Operative Risk Evaluation II (p=0.164), but it was statistically significant for the logistic European System for Cardiac Operative Risk Evaluation (p=0.031). The areas under the receiver operating characteristic curves are statistically different from 0.5 for both models (additive and logistic European System for Cardiac Operative Risk Evaluation), as well as for the European System for Cardiac Operative Risk Evaluation II. However, the proper classification of the patients has not been observed since their sensitivity and specificity are not satisfactory. Conclusion. The additive and logistic European Systems for Cardiac Operative Risk Evaluation overestimate while the European System for Cardiac Operative Risk Evaluation II underestimates the risk in cardiac surgery. We believe that a locally derived model would be of great use in the everyday clinical practice since it would faithfully illustrate the actual state of patient population of the region where it was developed. At the same time it would provide the accurate prediction of surgical outcome.

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