Key result
The CASUS score on postoperative day 2 accurately predicted mortality with an AUC of 79.8%, significantly outperforming EuroSCORE (AUC 45.3%).
Why the study?
The study was planned to evaluate the effectiveness of the cardiac surgery score (CASUS) system for predicting mortality after cardiac surgery and to compare it with EuroSCORE.
Does the CASUS scoring system improve mortality prediction compared to EuroSCORE in patients with prolonged ICU stay after cardiac surgery?
Observational (n=50)
No
Does the CASUS scoring system improve mortality prediction compared to EuroSCORE in patients with prolonged ICU stay after cardiac surgery?
Absolute Event Rate: 79.8% vs 45.3%
p-value: p=<0.03
The CASUS score on postoperative day 2 is a more effective predictor of mortality than the preoperative EuroSCORE in cardiac surgery patients with prolonged ICU stays.
May support CASUS over EuroSCORE for day-2 mortality prediction in prolonged ICU stays; leaves open prospective validation.
Objective: This study was planned to evaluate effectiveness of cardiac surgery score (CASUS) system used for the prediction of mortality after the cardiac surgery and to compare it with EuroSCORE, a tested and approved method. Method: Fifty patients over the age of 18 who came to the intensive care unit (ICU) after open heart surgery and stayed in the ICU for more than 48 hours were prospectively included in the study. After the preoperative EuroSCORE evaluation of the patients, CASUS scoring systems were used for risk scoring from postoperative 0 day to the service or up to the 6th postoperative day (or possible mortality) in patients whose stay in ICU was prolonged. We evaluated the place of both models in the prediction of ICU mortality. Results: The study was conducted with 50 patients- 21 female, 29 male-, aged between 19 and 79 years (mean age: 60.38±12.50). Five (10%) cases exited.The areas under the ROC curve were estimated as follows: EuroSCORE, 45.3%; and for CASUS 0,1, and 2. day scores AUCs of ROC curve were 66,9%, 64,7%, and 79,8%, respectively. The CASUS 2nd day score was found to be valuable in predicting mortality (p<0.01). A statistically significant relationship was observed between the days of stay in the ICU and mortality. Conclusion: Our results show that the rate of the accurate prediction of mortality of CASUS is insufficient on postop 0th and 1st day; however CASUS score on postoperative 2nd day has sufficient.predictive accuracy EuroSCORE is not found effective in the prediction of mortality. It is observed that if the duration of stay in ICU is prolonged, it statistically significantly increases the risk of mortality.
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Polat et al. (2021) conducted an observational in Post-open heart surgery patients requiring prolonged ICU stay (n=50). CASUS scoring system vs. EuroSCORE was evaluated on Prediction of mortality (Area under the ROC curve) (p=<0.03). The CASUS score on postoperative day 2 accurately predicted mortality with an AUC of 79.8%, significantly outperforming EuroSCORE (AUC 45.3%).
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