Abstract
BackgroundMortality after coronary artery bypass grafting (CABG) is generally associated with underlying disease and surgical factors overlooked in preoperative prognostic models. Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE II) scores are widely used in intensive care units for outcome prediction. This study investigated the accuracy of these models in predicting mortality.MethodsBetween January 2010 and April 2013, 483 patients who underwent isolated CABG were enrolled. The clinical characteristics, outcomes, and prognostic model scores of the patients were collected. Discrimination was assessed using the area under the curve approach.ResultsBoth SOFA and APACHE II scores were effective for predicting in-hospital mortality. Among the organ systems examined in the SOFA, the cardiac and renal systems were the strongest predictors of CABG mortality. Multivariate analysis identified only the SOFA score as being an independent risk factor for mortality.ConclusionIn summary, the SOFA score can be used to accurately identify mortality after isolated CABG.
Highlights
Mortality after coronary artery bypass grafting (CABG) is generally associated with underlying disease and surgical factors overlooked in preoperative prognostic models
Compared with the survival group, the mortality group was older, was more likely to have end-stage renal disease (ESRD), and was more likely to be on ventilator support before surgery
The nonsurvivors required the surgery more urgently and had more intraoperative intra-aortic balloon pumping (IABP) and extracorporeal membrane oxygenation (ECMO) usage compared with the survivors
Summary
Mortality after coronary artery bypass grafting (CABG) is generally associated with underlying disease and surgical factors overlooked in preoperative prognostic models. Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE II) scores are widely used in intensive care units for outcome prediction. This study investigated the accuracy of these models in predicting mortality. Prognostic models developed by the Society of Thoracic Surgeons European System for Cardiac Operative Risk Evaluation for mortality and morbidity are widely used before operations. General severity scoring systems, such as the Acute Physiology and Chronic Health Evaluation (APACHE II) [4] and Sequential Organ Failure Assessment (SOFA) [5], are generally used in intensive care units (ICUs) to predict mortality, but their validity in isolated coronary
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