Key result
The APACHE II score independently predicted mortality after open heart surgery with an area under the curve of 0.878, sensitivity of 80%, and specificity of 78.5%.
Why the study?
Various risk scores have been developed to predict mortality after cardiac surgery with notable differences among them, warranting evaluation of the accuracy of APACHE II, SOFA, and CASUS scores.
Do APACHE II, SOFA, and CASUS scores accurately predict mortality in adult patients undergoing open heart surgery?
Observational (n=103)
Do APACHE II, SOFA, and CASUS scores accurately predict mortality in adult patients undergoing open heart surgery?
The APACHE II score is a highly accurate tool for predicting mortality after open heart surgery, outperforming the CASUS score.
APACHE II may aid postoperative mortality prediction in cardiac surgery; leaves open prospective validation before routine use.
Abstract: Background: Mortality is the most commonly used outcome measure after cardiac surgery. Various risk scores were developed to predict mortality after cardiac surgery with many differences among these scores. We evaluated the accuracy of Acute Physiology And Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score and Cardiac Surgery Score (CASUS) in predicting mortality in our patient population. Methods: Between October 2015 and December 2017, 103 adult patients who underwent open heart surgery were evaluated. The clinical characteristics, outcomes and risk scores data of the patients were collected. Accuracy of the scores was assessed using receiver operating curve (ROC) and the multivariate logistic regression analysis. Results: 103 patients were enrolled with mortality rate of 10.3%. The non-survivors group showed statistically significant lower E.F, higher platelet count, higher bilirubin level and lower Po2 level (P value: 0.015, 0.020, 0.038, 0.006) respectively. Both APACHE II and SOFA scores performed better than CASUS score in predicting mortality in this study. However, APACHE II score (Area Under Curve “AUC”:0.878, sensitivity: 80%, specificity: 78.5%) and the preoperative platelet count independently predicted mortality after cardiac surgery. Conclusion: Both APACHE II and SOFA scores showed a high power in predicting mortality after cardiac surgery but APACHE II score rises as the best tool for risk stratification in our patient population. Keywords: Mortality; Cardiac surgery; Risk scores.
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Elhamshary et al. (2018) conducted an observational in Open heart surgery (n=103). APACHE II, SOFA, and CASUS scores was evaluated on Mortality (AUC 0.878). The APACHE II score independently predicted mortality after open heart surgery with an area under the curve of 0.878, sensitivity of 80%, and specificity of 78.5%.
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