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Stratification of complexity in congenital heart surgery: comparative study of the Risk Adjustment for Congenital Heart Surgery (RACHS-1) method, Aristotle basic score and Society of Thoracic Surgeons-European Association for Cardio- Thoracic Surgery (STS-EACTS) mortality score.
Cavalcanti, Paulo Ernando Ferraz; Sá, Michel Pompeu Barros de Oliveira; Santos, Cecília Andrade dos; Esmeraldo, Isaac Melo; Chaves, Mariana Leal; Lins, Ricardo Felipe de Albuquerque; Lima, Ricardo de Carvalho.
Afiliação
  • Cavalcanti PE; Universidade de Pernambuco, Recife, PE, Brazil.
  • Sá MP; Universidade de Pernambuco, Recife, PE, Brazil.
  • Santos CA; Universidade de Pernambuco, Recife, PE, Brazil.
  • Esmeraldo IM; Universidade de Pernambuco, Recife, PE, Brazil.
  • Chaves ML; Universidade de Pernambuco, Recife, PE, Brazil.
  • Lins RF; Universidade de Pernambuco, Recife, PE, Brazil.
  • Lima Rde C; Universidade de Pernambuco, Recife, PE, Brazil.
Rev Bras Cir Cardiovasc ; 30(2): 148-58, 2015.
Article em En | MEDLINE | ID: mdl-26107445
OBJECTIVE: To determine whether stratification of complexity models in congenital heart surgery (RACHS-1, Aristotle basic score and STS-EACTS mortality score) fit to our center and determine the best method of discriminating hospital mortality. METHODS: Surgical procedures in congenital heart diseases in patients under 18 years of age were allocated to the categories proposed by the stratification of complexity methods currently available. The outcome hospital mortality was calculated for each category from the three models. Statistical analysis was performed to verify whether the categories presented different mortalities. The discriminatory ability of the models was determined by calculating the area under the ROC curve and a comparison between the curves of the three models was performed. RESULTS: 360 patients were allocated according to the three methods. There was a statistically significant difference between the mortality categories: RACHS-1 (1) - 1.3%, (2) - 11.4%, (3)-27.3%, (4) - 50 %, (P<0.001); Aristotle basic score (1) - 1.1%, (2) - 12.2%, (3) - 34%, (4) - 64.7%, (P<0.001); and STS-EACTS mortality score (1) - 5.5 %, (2) - 13.6%, (3) - 18.7%, (4) - 35.8%, (P<0.001). The three models had similar accuracy by calculating the area under the ROC curve: RACHS-1- 0.738; STS-EACTS-0.739; Aristotle- 0.766. CONCLUSION: The three models of stratification of complexity currently available in the literature are useful with different mortalities between the proposed categories with similar discriminatory capacity for hospital mortality.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Mortalidade Hospitalar / Risco Ajustado / Cardiopatias Congênitas / Procedimentos Cirúrgicos Cardíacos Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Região como assunto: America do sul / Brasil Idioma: En Ano de publicação: 2015 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Mortalidade Hospitalar / Risco Ajustado / Cardiopatias Congênitas / Procedimentos Cirúrgicos Cardíacos Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Região como assunto: America do sul / Brasil Idioma: En Ano de publicação: 2015 Tipo de documento: Article