Abstract
This study compared the performance of risk adjustment for congenital heart surgery (RACHS-1) score with paediatric risk of mortality (PRISM) score in operative risk prediction after open-heart surgery in children. This was a retrospective analysis of a non-selected patient population from the paediatric intensive care unit of Helsinki University Hospital. All consecutive congenital open-heart surgery patients operated in Finland between the years 2000 and 2004, who were under 18 years of age, were included in this retrospective analysis. Predicted probability of mortality was calculated using the published algorithms for RACHS-1 and PRISM. Those were compared with observed mortality at day 30 postoperatively. Of the 1001 patients, 42 patients died (4.2%) within 30 days of open-heart surgery. The discrimination power, evaluated by AUC (area under curve) for RACHS-1 was moderate: 0.74 (95% CI 0.66-0.82). The AUC-value for PRISM was poor, namely 0.66 (95% CI 0.57-0.75). Both risk scoring systems overestimated the mortality with calculated standardised mortality ratios (SMR) of 0.48 for PRISM and 0.39 for RACHS-1. With only a moderate discriminating AUC, RACHS-1 failed to adequately predict death after paediatric open-heart surgery. The predictive power of PRISM in this patient group was poor. Both scores overestimated the actual mortality rate.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
