Impacto do tipo de procedimento e do fator cirurgião na validação do EuroSCORE
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| Formato: | Artículo científico |
| Lenguaje: | pt |
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Sociedade Brasileira de Cirurgia Cardiovascular
2014
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| _version_ | 1876490629899354112 |
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| author | Fernando A. Atik |
| author_facet | Fernando A. Atik |
| contents | Impacto do tipo de procedimento e do fator cirurgião na validação do EuroSCORE Fernando A. Atik Claudio Ribeiro da Cunha Medicina methods Logistic Models Risk Assessment Quality of Health Care Cardiovascular Surgical Procedures Objective: EuroSCORE has been used in cardiac surgery operative risk assessment, despite important variables were not included. The objective of this study was to validate EuroSCORE on mortality prediction in a Brazilian cardiovascular surgery cen - ter, defining the influence of type of procedure and surgical team. Methods: Between January 2006 and June 2011, 2320 con - secutive adult patients were studied. According to additive Euro - SCORE, patients were divided into low risk (score<2), medium risk (3 - 5), high risk (6 - 11) and very high risk (>12). The rela - tion between observed mortality (O) and expected mortality (E) according to logistic EuroSCORE was calculated for each of the groups, types of procedures and surgeons with > 150 operations, and analyzed by logistic regression. Results: EuroSCORE correlated to the observed mortality (O/E=0.94; P <0.0001; area under the curve 0.78). However, it overestimated the mortality in very high risk patients (O/ E=0.74; P =0.001). EuroSCORE tended to overestimate isolated myocardial revascularization mortality (O/E=0.81; P =0.0001) and valve surgery mortality (O/E=0.89; P =0.007) and it tended to underestimate combined procedures mortality (O/E=1.09; P <0.0001). EuroSCORE overestimated surgeon A mortality (O/ E=0.46; P <0.0001) and underestimated surgeon B mortality (O/ E=1.3; P <0.0001), in every risk category. Conclusion: In the present population, EuroSCORE overes - timates mortality in very high risk patients, being influenced by type of procedure and surgical team. The most appropriate sur - gical team may minimize risks imposed by preoperative profiles. 2014 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398941893005 pt http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.2 Vol.29 |
| format | Artículo científico |
| id | redalyc_398941893005 |
| institution | Redalyc |
| language | pt |
| publishDate | 2014 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| spellingShingle | Impacto do tipo de procedimento e do fator cirurgião na validação do EuroSCORE Fernando A. Atik Medicina methods Logistic Models Risk Assessment Quality of Health Care Cardiovascular Surgical Procedures Impacto do tipo de procedimento e do fator cirurgião na validação do EuroSCORE Fernando A. Atik Claudio Ribeiro da Cunha Medicina methods Logistic Models Risk Assessment Quality of Health Care Cardiovascular Surgical Procedures Objective: EuroSCORE has been used in cardiac surgery operative risk assessment, despite important variables were not included. The objective of this study was to validate EuroSCORE on mortality prediction in a Brazilian cardiovascular surgery cen - ter, defining the influence of type of procedure and surgical team. Methods: Between January 2006 and June 2011, 2320 con - secutive adult patients were studied. According to additive Euro - SCORE, patients were divided into low risk (score<2), medium risk (3 - 5), high risk (6 - 11) and very high risk (>12). The rela - tion between observed mortality (O) and expected mortality (E) according to logistic EuroSCORE was calculated for each of the groups, types of procedures and surgeons with > 150 operations, and analyzed by logistic regression. Results: EuroSCORE correlated to the observed mortality (O/E=0.94; P <0.0001; area under the curve 0.78). However, it overestimated the mortality in very high risk patients (O/ E=0.74; P =0.001). EuroSCORE tended to overestimate isolated myocardial revascularization mortality (O/E=0.81; P =0.0001) and valve surgery mortality (O/E=0.89; P =0.007) and it tended to underestimate combined procedures mortality (O/E=1.09; P <0.0001). EuroSCORE overestimated surgeon A mortality (O/ E=0.46; P <0.0001) and underestimated surgeon B mortality (O/ E=1.3; P <0.0001), in every risk category. Conclusion: In the present population, EuroSCORE overes - timates mortality in very high risk patients, being influenced by type of procedure and surgical team. The most appropriate sur - gical team may minimize risks imposed by preoperative profiles. 2014 artículo científico 0102-7638 https://www.redalyc.org/articulo.oa?id=398941893005 pt http://www.redalyc.org/revista.oa?id=3989 Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery application/pdf Sociedade Brasileira de Cirurgia Cardiovascular Revista Brasileira de Cirurgia Cardiovascular/Brazilian Journal of Cardiovascular Surgery (Brasil) Num.2 Vol.29 |
| title | Impacto do tipo de procedimento e do fator cirurgião na validação do EuroSCORE |
| topic | Medicina methods Logistic Models Risk Assessment Quality of Health Care Cardiovascular Surgical Procedures |
| url | https://www.redalyc.org/articulo.oa?id=398941893005 |