EuroScore II and frailty scales showed low predictability for postoperative complications, while EuroScore II demonstrated the highest prognostic value for predicting in-hospital mortality (AUC 0.816) in elderly cardiac surgery patients.
Observational (n=57)
No
Do frailty scales (Edmonton Frail Scale, Clinical Frailty Scale) better predict postoperative outcomes compared to standard risk scales (CARE, EuroScore II) in elderly patients undergoing open heart surgery?
EuroScore II and frailty scales both offer prognostic value for postoperative outcomes in elderly cardiac surgery patients, though EuroScore II demonstrated the highest sensitivity for predicting in-hospital mortality.
Estimación del efecto: AUC 0.652 for Edmonton Frail Scale vs AUC 0.665 for EuroScore II
valor p: p=not significant
BACKGROUND: In the last year there has been an increasing interest for using frailty scales for risk stratification of elderly patients undergoing major surgery. We planned to compare two frailty scales with risk scales already used in cardiac surgery, to study which of these scores have better prognostic value predicting postoperative outcome in open heart surgery. METHODS: We conducted a prospective clinical trial, including 57 patients over 65 years. We calculated Cardiac Anesthesia Risk Evaluation score, EuroScore II, Clinical Frailty Scale, Edmonton Frail Scale for each patient and followed the postoperative complications, length of mechanical ventilation, length of stay in the intensive care unit and hospital, and in-hospital death related to these risk and frailty scores. RESULTS: Postoperative complications occurred in 25 patients (43.9%), while four patients (7%) died with multiple organ failure. All scales had low predictability for postoperative complications, but for length of mechanical ventilation we obtained positive correlations with EuroScore II, Edmonton Frail Scale and Clinical Frailty Scale. EuroScore II can also predict the length of stay in the intensive care unit. For postoperative deaths, the highest sensitivity had EuroScore II, followed by Clinical Frailty Scale and Edmonton Frail Scale. CONCLUSIONS: EuroScore II and the frailty scales have an increased prognostic value regarding the postoperative outcome of patients (length of mechanical ventilation and in-hospital mortality), the EuroScore II can predict the length of stay in the intensive care unit as well.
Kovács et al. (Sun,) llevaron a cabo un estudio observacional en cirugía cardíaca abierta (n=57). Se evaluaron las escalas de fragilidad (Escala de Fragilidad de Edmonton, Escala de Fragilidad Clínica) frente a las escalas de riesgo quirúrgico (CARE, EuroScore II) en la predicción de complicaciones postoperatorias (AUC 0.652 para la Escala de Fragilidad de Edmonton frente a AUC 0.665 para EuroScore II, p= no significativo). EuroScore II y las escalas de fragilidad mostraron baja predictibilidad para complicaciones postoperatorias, mientras que EuroScore II demostró el mayor valor pronóstico para predecir la mortalidad intrahospitalaria (AUC 0.816) en pacientes ancianos de cirugía cardíaca.
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