P-39 Can SAPSII score predict the outcomes of cardiac surgical patients?

Abstract

Introduction. Several prognostic systems have been validated in general Intensive Care Units but very few after cardiac surgery. The purpose of this prospective observational cohort study was to investigate whether Simplified Acute Physiology Score (SAPS) can predict the outcomes of cardiac surgical patients. Method. One-hundred and fifteen patients scheduled for cardiac surgery were divided into two groups depending on SAPS II on post operating day 1: 24 patients (group H) with SAPS II 25 (its predicted mortality was about 5%, twice the overall mortality) and 91 patients (group L) with SAPS II 25 28 day mortality, duration of mechanical ventilation, Intensive care unit length of stay (ICU LOS), hospital length of stay (hospital LOS) and incidence of postoperative complication were compared between groups. Statistical analysis was performed with unpaired t test, Mann-Whitney U test and Fisher’s exact test. P 0.05 was considered statistically significant. All values are shown as mean standard deviation. Results. Group demographics were comparable, except patients in group H were significantly older than group L (66.5 11.1 yr vs. 57.7 15.1 yr). 28 day mortalities were significantly higher in group H (12.5% vs. 0%). The ICU LOS (273.8 489.3 vs. 103.3 173.2 h), hospital LOS (34.8 22.8 vs. 25.6 16.1 days) and duration of mechanical ventilation (74.8 110.0 vs. 37.9 150.9 hr) was significantly longer in group H. The incidences of total bilirubin 5mg/dl (33.3% vs. 7.7%), pneumonia (16.7% vs. 2.2%), acute kidney injury (33.3% vs. 8.8%), new onset of haemodyalysis (16.7% vs. 0%), were significantly higher in group H. The incidences of mediastinitis and surgical site infection (4.2% vs. 7.7%), elevation of hepatic enzymes (50.0% vs. 44.0%) were similar in both groups. Conclusions. SAPS II 25 resulted in prolonged duration of mechanical ventilation, ICU LOS and hospital LOS. The incidence of postoperative complication was higher in patients have SAPS II 25. SAPS II seems to predict the outcomes of cardiac surgical patients.