scholarly journals Multicenter prospective validation of the European System for Cardiac Operative Risk Evaluation II in Argentina

Author(s):  
Raúl A. Borracci ◽  
Miguel Rubio ◽  
Julio Baldi-Jr ◽  
Julio C. Giorgini ◽  
Claudio C. Higa
2014 ◽  
Vol 67 (11-12) ◽  
pp. 367-371
Author(s):  
Bogoljub Mihajlovic ◽  
Bojan Mihajlovic ◽  
Milica Panic ◽  
Milana Jarakovic ◽  
Snezana Bjelica ◽  
...  

Introduction. During the last two decades, many authors have found that European Systems for Cardiac Operative Risk Evaluation (additive and logistic models) overestimate the risk in cardiac surgery. The new European model has recently been introduced as an update to previous versions. The aim of the study was to investigate the significance of locally derived system for cardiac operative risk evaluation and to compare its predictive power with the existing European systems. Material and Methods. For developing a local risk prediction model, data from 2681 patients submitted to cardiac surgery at the Institute of Cardiovascular Diseases Vojvodina have thoroughly been collected. Logistic regression analysis was used to construct a local model for prediction of outcome. The evaluation of the local model and three European systems was performed by comparing the observed and expected hospital mortality. Results. The difference between the predicted and observed mortality regardless of the type of surgery was statistically insignificant for the additive European system (p=0.073) and the local model (p=0.134). The logistic European system overestimated the operative risk, while the new European model underestimated mortality. In coronary surgery, all models, except the logistic European system, performed well. In valvular surgery, the new European model and the local model underestimated mortality significantly, while the additive and logistic European models performed well. In combined surgery, the new European system significantly underestimated mortality (p=0.029), while the local model performed well (p=0.252). Conclusion. The locally derived model shows satisfactory results, with good calibration and discriminative power. The local model specifically outperforms all other European systems in terms of discriminatory power in combined surgery subset.


2018 ◽  
Vol 10 (3) ◽  
pp. 175
Author(s):  
Donni Indra Kusuma ◽  
Heru Dwi Jatmiko

Meskipun perkembangan ilmu kedokteran mengenai patofisiologi penyakit kardiovaskular sudah berkembang, namun penyakit ini tetap menjadi penyebab kematian terbanyak di seluruh dunia. Bedah jantung menawarkan potensi yang cukup menguntungkan bagi sebagian besar pasien. Berbagai macam cara dilakukan untuk mengoptimalkan hasil dari bedah jantung dan menurunkan tingkat mortalitas pascaoperasi. Salah satu cara yang dapat dilakukan adalah penilaian praoperasi pasien sebelum melakukan bedah jantung. Penilaian praoperasi pasien yang akan dilakukan operasi jantung meliputi empat hal utama, yaitu anamnesis, pemeriksaan fisik, pemeriksaan laboratorium, dan pemeriksaan kardiologi.Penilaian risiko diperlukan oleh dokter anestesi untuk menilai faktor-faktor risiko yang dimiliki pasien dan bagaimana pengaruhnya dengan tingkat mortalitas pasien apabila dilakukan operasi jantung. Sistem penilaian yang sering digunakan antara lain indeks risiko jantung praoperasi dari Detsky, sistem penilaian European System for Cardiac Operative Risk Evaluation (EuroSCORE), dan Cardiac Anaesthesia Risk Evaluation Score (CARE). American College of Cardiology (ACC) dan American Heart Association (AHA) menyusun sebuah algoritme mengenai pendekatan dalam pemeriksaan jantung praoperasi. Algoritme ini membantu dokter dalam memberikan informed consent dan sebagai panduan dalam manajemen perioperatif untuk meminimalkan risiko.


1999 ◽  
Vol 16 (1) ◽  
pp. 9-13 ◽  
Author(s):  
S.A.M. Nashef ◽  
F. Roques ◽  
P. Michel ◽  
E. Gauducheau ◽  
S. Lemeshow ◽  
...  

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