Department of Internal Medicine and Diagnosis Support, Escola de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
Department of Cardiac Surgery, Hospital Santa Izabel, Salvador, Bahia, Brazil.
Braz J Cardiovasc Surg. 2021 Aug 6;36(4):492-499. doi: 10.21470/1678-9741-2020-0339.
Risk scores are important tools for predicting adverse events in cardiac surgery, but their accuracy varies when applied to different populations. The objective of this study is to evaluate the performance of the Brazilian score InsCor as a predictor of mortality after coronary artery bypass grafting (CABG) compared to the European System for Cardiac Operative Risk Evaluation (EuroSCORE) and Society of Thoracic Surgeons (STS) scores.
This is an observational and retrospective study, with patients undergoing surgical myocardial revascularization in a cardiology hospital in Salvador (Bahia, Brazil), between 2010 and 2015. InsCor, STS, and EuroSCORE were compared for accuracy in predicting mortality within 30 days after surgery. Discrimination capacity of models was assessed using areas under receiver operating characteristic (ROC) curves. Significance level was 5%.
Four hundred sixty-one patients were evaluated (mean age 63 [± 8.6] years, 77% men). Thirty-day mortality was 2.6%. InsCor classified 88, 210, and 163 patients as having low, medium, and high risk of death, respectively. According to EuroSCORE and STS, 379 and 430 patients were classified as having low risk and 77 and 29 as medium risk, respectively. Area under the ROC curve was 0.734 (P=0.002) for InsCor, 0.615 (P=0.027) for EuroSCORE, and 0.623 (P=0.033) for STS. ROC curve of InsCor maintained statistical significance after adjustment for other models.
The InsCor score, derived from a Brazilian sample, showed good predictive accuracy of death up to 30 days in patients undergoing CABG in relation to STS and EuroSCORE scores.
风险评分是预测心脏手术不良事件的重要工具，但在应用于不同人群时，其准确性存在差异。本研究旨在评估巴西 InsCor 评分作为预测冠状动脉旁路移植术（CABG）后死亡率的指标的表现，与欧洲心脏手术风险评估系统（EuroSCORE）和胸外科医生协会（STS）评分进行比较。
这是一项观察性和回顾性研究，纳入了 2010 年至 2015 年在巴伊亚州萨尔瓦多（巴西）心脏病医院接受手术心肌血运重建的患者。比较 InsCor、STS 和 EuroSCORE 在预测术后 30 天内死亡率方面的准确性。通过受试者工作特征（ROC）曲线下面积评估模型的区分能力。显著性水平为 5%。
共评估了 461 例患者（平均年龄 63 [±8.6] 岁，77%为男性）。30 天死亡率为 2.6%。InsCor 将 88、210 和 163 例患者分别归类为低、中、高死亡风险。根据 EuroSCORE 和 STS，379 例和 430 例患者被归类为低风险，77 例和 29 例患者被归类为中风险。InsCor 的 ROC 曲线下面积为 0.734（P=0.002），EuroSCORE 为 0.615（P=0.027），STS 为 0.623（P=0.033）。InsCor 的 ROC 曲线在调整其他模型后仍具有统计学意义。
InsCor 评分源自巴西样本，在预测 CABG 患者 30 天内死亡方面具有良好的准确性，优于 STS 和 EuroSCORE 评分。
