Key result
The additive EuroSCORE showed appropriate calibration (P=0.596) and discrimination (AUC 0.79) for predicting mortality in cardiac surgery patients, whereas the 2000 Bernstein-Parsonnet model proved inadequate (calibration P=0.047).
Why the study?
Do the 2000 Bernstein-Parsonnet and additive EuroSCORE models accurately predict mortality in patients undergoing coronary bypass or heart valve surgery?
Observational (n=3,000)
No
Do the 2000 Bernstein-Parsonnet and additive EuroSCORE models accurately predict mortality in patients undergoing coronary bypass or heart valve surgery?
Effect estimate: AUC ES 0.79, 2000BP 0.80
p-value: p=ES calibration P=0.596, 2000BP calibration P=0.047
The additive EuroSCORE is an appropriate model for predicting mortality in patients undergoing CABG or valve surgery at this institution, whereas the 2000 Bernstein-Parsonnet score showed inadequate calibration.
Supports additive EuroSCORE for local mortality prediction; leaves generalizability of both models open.
OBJECTIVE: To validate the 2000 Bernstein Parsonnet (2000BP) and additive EuroSCORE (ES) to predict mortality in patients who underwent coronary bypass surgery and/or heart valve surgery at the Heart Institute, University of São Paulo (InCor/HC-FMUSP). METHODS: A prospective observational design. We analyzed 3000 consecutive patients who underwent coronary bypass surgery and/or heart valve surgery, between May 2007 and July 2009 at the InCor/HC-FMUSP. Mortality was calculated with the 2000BP and ES models. The correlation between estimated mortality and observed mortality was validated by calibration and discrimination tests. RESULTS: There were significant differences in the prevalence of risk factors between the study population, 2000BP and ES. Patients were stratified into five groups for 2000BP and three for the ES. In the validation of models, the ES showed good calibration (P = 0.596), however, the 2000BP (P = 0.047) proved inadequate. In discrimination, the area under the ROC curve proved to be good for models, ES (0.79) and 2000BP (0.80). CONCLUSION: In the validation, 2000BP proved questionable and ES appropriate to predict mortality in patients who underwent coronary bypass surgery and/or heart valve surgery at the InCor/HC-FMUSP.
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Mejía et al. (2012) conducted an observational in Patients undergoing coronary bypass surgery and/or heart valve surgery (n=3,000). 2000 Bernstein Parsonnet (2000BP) and additive EuroSCORE (ES) models was evaluated on Mortality prediction (calibration and discrimination) (AUC ES 0.79, 2000BP 0.80, p=ES calibration P=0.596, 2000BP calibration P=0.047). The additive EuroSCORE showed appropriate calibration (P=0.596) and discrimination (AUC 0.79) for predicting mortality in cardiac surgery patients, whereas the 2000 Bernstein-Parsonnet model proved inadequate (calibration P=0.047).
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