Sá Michel Pompeu Barros de Oliveira, Sá Marcus Villander Barros de Oliveira, Albuquerque Ana Carla Lopes de, Silva Belisa Barreto Gomes da, Siqueira José Williams Muniz de, Brito Phabllo Rodrigo Santos de, Vasconcelos Frederico Pires, Lima Ricardo de Carvalho
Rev Bras Cir Cardiovasc. 2012 Jan-Mar;27(1):1-6. doi: 10.5935/1678-9741.20120003.
The aim of this study is to evaluate the applicability of GuaragnaSCORE for predicting mortality in patients undergoing heart valve surgery in the Division of Cardiovascular Surgery of Pronto Socorro Cardiológico de Pernambuco - PROCAPE, Recife, PE, Brazil.
Retrospective study involving 491 consecutive patients operated between May/2007 and December/2010. The registers contained all the information used to calculate the score. The outcome of interest was death. Association of model factors with death (univariate analysis and multivariate logistic regression analysis), association of risk score classes with death and accuracy of the model by the area under the ROC (receiver operating characteristic) curve were calculated.
The incidence of death was 15.1%. The nine variables of the score were predictive of perioperative death in both univariate and multivariate analysis. We observed that the higher the risk class of the patient (low, medium, high, very high, extremely high), the greater is the incidence of postoperative AF (0%; 7.2%; 25.5%; 38.5%; 52.4%), showing that the model seems to be a good predictor of risk of postoperative death, in a statistically significant association (P <0.001). The score presented a good accuracy, since the discrimination power of the model in this study according to the ROC curve was 78.1%.
The Brazilian score proved to be a simple and objective index, revealing a satisfactory predictor of perioperative mortality in patients undergoing heart valve surgery at our institution.
本研究旨在评估瓜拉尼亚评分（GuaragnaSCORE）在巴西累西腓市佩尔南布哥心脏急救中心（PROCAPE）心血管外科进行心脏瓣膜手术患者中预测死亡率的适用性。
回顾性研究纳入了2007年5月至2010年12月期间连续接受手术的491例患者。登记册包含了用于计算该评分的所有信息。感兴趣的结局是死亡。计算模型因素与死亡的关联（单因素分析和多因素逻辑回归分析）、风险评分类别与死亡的关联以及通过ROC（受试者工作特征）曲线下面积评估模型的准确性。
死亡率为15.1%。评分的九个变量在单因素和多因素分析中均能预测围手术期死亡。我们观察到患者的风险类别越高（低、中、高、非常高、极高），术后房颤的发生率越高（0%；7.2%；25.5%；38.5%；52.4%），表明该模型似乎是术后死亡风险的良好预测指标，具有统计学显著关联（P<0.001）。该评分具有良好的准确性，因为根据ROC曲线，本研究中模型的鉴别能力为78.1%。
巴西评分被证明是一个简单且客观的指标，在我们机构中是心脏瓣膜手术患者围手术期死亡率的一个令人满意的预测指标。
