scholarly journals Assessment of three risk evaluation systems for patients aged ≥70 in East China: performance of SinoSCORE, EuroSCORE II and the STS risk evaluation system

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e4413 ◽  
Author(s):  
Lingtong Shan ◽  
Wen Ge ◽  
Yiwei Pu ◽  
Hong Cheng ◽  
Zhengqiang Cang ◽  
...  
Keyword(s):  
Risk Evaluation ◽  
Evaluation System ◽  
Artery Bypass ◽  
Characteristic Curve ◽  
The Elderly ◽  
Elderly Group ◽  
East China ◽  
Entire Cohort ◽  
Evaluation Systems ◽  
Risk Evaluation System

Objectives To assess and compare the predictive ability of three risk evaluation systems (SinoSCORE, EuroSCORE II and the STS risk evaluation system) in patients aged ≥70, and who underwent coronary artery bypass grafting (CABG) in East China. Methods Three risk evaluation systems were applied to 1,946 consecutive patients who underwent isolated CABG from January 2004 to September 2016 in two hospitals. Patients were divided into two subsets according to their age: elderly group (age ≥70) with a younger group (age <70) used for comparison. The outcome of interest in this study was in-hospital mortality. The entire cohort and subsets of patients were analyzed. The calibration and discrimination in total and in subsets were assessed by the Hosmer–Lemeshow and the C statistics respectively. Results Institutional overall mortality was 2.52%. The expected mortality rates of SinoSCORE, EuroSCORE II and the STS risk evaluation system were 0.78(0.64)%, 1.43(1.14)% and 0.78(0.77)%, respectively. SinoSCORE achieved the best discrimination (the area under the receiver operating characteristic curve (AUC) = 0.829), followed by the STS risk evaluation system (AUC = 0.790) and EuroSCORE II (AUC = 0.769) in the entire cohort. In the elderly group, the observed mortality rate was 4.82% while it was 1.38% in the younger group. SinoSCORE (AUC = .829) also achieved the best discrimination in the elderly group, followed by the STS risk evaluation system (AUC = .730) and EuroSCORE II (AUC = 0.640) while all three risk evaluation systems all had good performances in the younger group. SinoSCORE, EuroSCORE II and the STS risk evaluation system all achieved positive calibrations in the entire cohort and subsets. Conclusion The performance of the three risk evaluation systems was not ideal in the entire cohort. In the elderly group, SinoSCORE appeared to achieve better predictive efficiency than EuroSCORE II and the STS risk evaluation system.

scholarly journals Predictive ability of EuroSCORE II integrating cardiactroponin T in patients undergoing OPCABG

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiang Li ◽  
Lingtong Shan ◽  
Mengwei Lv ◽  
Zhi Li ◽  
Chunyan Han ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Risk Evaluation ◽  
Evaluation System ◽  
Myocardial Injury ◽  
Predictive Ability ◽  
Discrimination Power ◽  
Evaluation Systems ◽  
Risk Evaluation System ◽  
Injury Classification

Abstract Background Preoperative risk evaluation systems are significant and important to the allocation of medical resources and the communication between doctors and patients. The European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) is widely used in clinical practice. Cardiac troponin T (cTnT) can specifically and accurately reflect myocardial injury. Whether EuroSCORE II can improve the predictive power after integrating with cTnT is still unclear. This study was a retrospective single center study designed to assess the predictive ability of EuroSCORE II integrated with cTnT for patients undergoing isolated off-pump coronary artery bypass grafting (OPCABG). Methods This retrospective and observational cohort study included 1887 patients who underwent first isolated OPCABG. cTnT was detected within 48 h before operation in each patient. According to myocardial injury, patients were divided by cTnT into 4 stages. A new risk evaluation system was created through logistic regression with EuroSCORE II and myocardial injury classification as covariates. Then the two risk evaluation systems were comparatively assessed by regression analysis, receiver operator characteristic curves, net reclassification index, Bland–Altman plots and decision curve analysis. Results There were 43 in-hospital deaths, with a mortality of 2.30% (43/1887). The logistic regression analysis showed that preoperative myocardial injury classification was a significant risk factor for in-hospital mortality in both total cohort (OR 1.491, 95%CI 1.049–2.119) and subsets (OR 1.761, 95%CI 1.102–2.814). The new risk evaluation system has higher calibration and discrimination power than EuroSCORE II, both for overall cohort and subsets. Especially, the new system has obvious advantages in discrimination power in the subset of acute myocardial infarction (AUC 0.813 vs. 0.772, 0.906 vs. 0.841, and 0.715 vs. 0.646, respectively). Conclusions Both myocardial injury classification and EuroSCORE II are independent risk factors of in-hospital mortality in OPCABG patients. The new risk evaluation system has higher predictive ability than EuroSCORE II, especially in patients with a recent history of AMI.

scholarly journals Perioperative Risk Assessment for Surgery of Consecutive Cases with Ventricular Septal Rupture: Seeking A Novel and Comprehensive Method

2021 ◽  
Vol 24 (3) ◽  
pp. E461-E466
Author(s):  
Lu Wang ◽  
Ting Hai ◽  
Yi Feng ◽  
Qiaoyu Han ◽  
Yaru Li ◽  
...  
Keyword(s):  
Risk Evaluation ◽  
Comprehensive Evaluation ◽  
Artery Bypass ◽  
Characteristic Curve ◽  
Univariate Analysis ◽  
Evaluation Process ◽  
Early Mortality ◽  
Ventricular Septal Rupture ◽  
Evaluation Systems ◽  
Single Center Experience

Background: Ventricular septal rupture (VSR) is a rare but lethal complication occurring after acute myocardial infarction. The aim of our study was to review the single-center experience of surgery for VSR and seek a comprehensive evaluation process for early mortality. Methods: Patients undergoing surgical repair for postinfarction VSR in our institution retrospectively were evaluated from Jan. 2006 to Dec. 2019. The endpoint of the study was mortality within 30 days after VSR surgery, which was divided into survivors and nonsurvivors. The calibration and discrimination of two risk evaluation systems (European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) and the Society of Thoracic Surgeons (STS) risk score) in total were compared by Hosmer-Lemeshow, and the area under the receiver operating characteristic curve (AUC). Risk factors in subsets were assessed by logistic regression analysis. Results: Twenty-three patients undergoing surgery for VSR repair were reviewed, and the early mortality after surgery was 34.8% (N = 8). The expected mortality predicted by EuroSCORE II was 24.3%, and that of the STS score was 12.2%. Both the EuroSCORE II and STS risk evaluation systems showed positive calibration in predicting mortality (H-L: P = 0.117 and P = 0.346, respectively) but poor discriminative power (AUC=0.633 and 0.575). Significant predictors determined by univariate analysis were concomitant coronary artery bypass grafting (CABG) (P = 0.035) and postoperative continuous renal replacement therapy (CRRT) (P = 0.008). Conclusion: Early mortality of VSR after surgery remains high, and the evaluation process is complicated. The performances of the two risk evaluation systems were not optimal, but EuroSCORE II was more accurate than STS. Patients with lower preoperation EuroSCORE II, concomitant CABG during repair, and no need for CRRT after surgery may have a better early survival rate.

Development and evaluation of an Agricultural Cumulative Risk Evaluation System (ACRES): An ergonomic tool usability study across various lifting and postural assessment systems for novice users

2021 ◽  
Vol 65 (1) ◽  
pp. 951-955
Author(s):  
Colten Fales ◽  
Richard T. Stone ◽  
Esraa Saleh Abdelall ◽  
Steffen Baumann
Keyword(s):  
Risk Evaluation ◽  
Evaluation System ◽  
Cumulative Risk ◽  
Assessment Tools ◽  
Usability Study ◽  
Evaluation Systems ◽  
Repetitive Tasks ◽  
Novice Users ◽  
Postural Assessment ◽  
Risk Evaluation System

This paper aims to compare agreeance of four of most commonly used ergonomics assessment tools as well as introduce the Agriculture Cumulative Risk Evaluation Systems (ACRES), a tool that assesses both lifting and posture. ACRES discretizes factors to evaluate ergonomic risk. Participants lacked substantial experience with ergonomic tools, but were given instruction guides for each tool and tasked with evaluating various lifting and repetitive tasks to help evaluate initial perceptions. Results showed that REBA, QEC, and ACRES all had significant correlations with a more linear relationship between REBA and ACRES than REBA and QEC. The NIOSH lifting equation and the Snook and Cirello tables were too different to have significant correlation whereas ACRES was able to correlate with RNLE. In all cases REBA and the RNLE were found to be more difficult to use to novices and ACRES was perceived to be more appropriate for the lifting tasks.

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