Key result
The ACEF Score showed questionable discrimination (AUC 0.625) and inadequate calibration (p=0.046) for predicting mortality in elective cardiac surgery compared to InsCor and EuroSCORE.
Why the study?
Does the ACEF Score accurately predict mortality compared to InsCor and EuroSCORE in patients undergoing elective CABG and/or heart valve surgery?
Cohort (n=2,565)
No
Does the ACEF Score accurately predict mortality compared to InsCor and EuroSCORE in patients undergoing elective CABG and/or heart valve surgery?
The ACEF Score is not as accurate as InsCor and EuroSCORE for predicting mortality in patients undergoing elective CABG or heart valve surgery in a Brazilian tertiary care center.
ACEF may not suit mortality prediction in elective cardiac surgery; leaves open optimal score selection in Brazilian cohorts.
BACKGROUND: Risk scores for cardiac surgery cannot continue to be neglected. OBJECTIVE: To assess the performance of "Age, Creatinine and Ejection Fraction Score" (ACEF Score) to predict mortality in patients submitted to elective coronary artery bypass graft and/or heart valve surgery, and to compare it to other scores. METHODS: A prospective cohort study was carried out with the database of a Brazilian tertiary care center. A total of 2,565 patients submitted to elective surgeries between May 2007 and July 2009 were assessed. For a more detailed analysis, the ACEF Score performance was compared to the InsCor's and EuroSCORE's performance through correlation, calibration and discrimination tests. RESULTS: Patients were stratified into mild, moderate and severe for all models. Calibration was inadequate for ACEF Score (p = 0.046) and adequate for InsCor (p = 0.460) and EuroSCORE (p = 0.750). As for discrimination, the area under the ROC curve was questionable for the ACEF Score (0.625) and adequate for InsCor (0.744) and EuroSCORE (0.763). CONCLUSION: Although simple to use and practical, the ACEF Score, unlike InsCor and EuroSCORE, was not accurate for predicting mortality in patients submitted to elective coronary artery bypass graft and/or heart valve surgery in a Brazilian tertiary care center.
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Mejía et al. (2015) conducted a cohort in Elective coronary artery bypass graft and/or heart valve surgery (n=2,565). ACEF Score vs. InsCor and EuroSCORE was evaluated on Mortality (AUC 0.625, p=0.046). The ACEF Score showed questionable discrimination (AUC 0.625) and inadequate calibration (p=0.046) for predicting mortality in elective cardiac surgery compared to InsCor and EuroSCORE.
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