Comparison between Sequential Organ Failure Assessment Score (SOFA) and Cardiac Surgery Score (CASUS) for Mortality Prediction after Cardiac Surgery
Comparison between Sequential Organ Failure Assessment Score (SOFA) and Cardiac Surgery Score (CASUS) for Mortality Prediction after Cardiac Surgery
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DOI：
10.1055/s-0030-1270943
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发表时间：
2012-02-01
影响因子：
1.5
通讯作者：
Hekmat, K.
中科院分区：
文献类型：
--
作者：
Badreldin, A. M. A.;Doerr, F.;Hekmat, K.
我们的目的是评估和比较“序贯器官衰竭评估”评分（SOFA）和“心脏手术评分”（CASUS）预测心脏手术后死亡率的准确性。方法在2007年1月1日至2008年12月31日期间，我们前瞻性地纳入了所有心脏手术后入住重症监护病房（ICU）的连续成年患者。两种评分系统从入ICU第1天（手术当天）至第7天每天计算一次。我们使用校正和判别统计对两种模型的ICU死亡率预测进行了评估。结果共纳入2801例患者，其中女性29.6%。平均年龄66.9±10.7岁。重症监护病房死亡率为5.2%。“序贯器官衰竭评估评分”和“心脏手术评分”的校准在所有天内都是可靠的（p >= 0.05）。与SOFA相比，CASUS在预测所有天的生存和死亡率方面更准确，这一点可以从接受者工作特征曲线下更大的区域得到证明。结论CASUS和SOFA是预测心脏手术后死亡率的可靠工具。然而，CASUS在预测个体患者死亡风险方面更为准确。因此，推荐在心脏外科重症监护病房使用CASUS。
Background Our purpose was to evaluate and compare the accuracy of the "Sequential Organ Failure Assessment" score (SOFA) and the "Cardiac Surgery Score" (CASUS) for the prediction of mortality after cardiac surgery.Methods Between January 1, 2007 and December 31, 2008 we prospectively included all consecutive adult patients admitted to our intensive care unit (ICU) after cardiac surgery. Both scoring systems were calculated daily from the 1st day in the ICU (day of operation) until the 7th ICU day. We evaluated the ICU mortality prediction of both models using calibration and discrimination statistics.Results 2801 patients (29.6% females) were included. Mean age was 66.9 +/- 10.7 years. Intensive care unit mortality was 5.2%. The calibration of the "Sequential Organ Failure Assessment Score" and "Cardiac Surgery Score" was reliable for all days (p >= 0.05). CASUS was more accurate in predicting survival and mortality compared to SOFA for all days, as evidenced by the larger areas under the Receiver Operating Characteristic curves.Conclusions Both CASUS and SOFA are reliable mortality prediction tools after cardiac surgery. However, CASUS was more accurate in predicting the individual patient's risk of mortality. Thus, use of the CASUS in cardiac surgery intensive care units is recommended.