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Báo cáo y học: "A comparative study of four intensive care outcome prediction models in cardiac surgery patients"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: A comparative study of four intensive care outcome prediction models in cardiac surgery patients. | Doerr et al. Journal of Cardiothoracic Surgery 2011 6 21 http www.cardiothoracicsurgery.Org content 6 1 21 JCTS JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access A comparative study of four intensive care outcome prediction models in cardiac surgery patients 1 1 1112 Fabian Doerr Akmal MA Badreldin Matthias B Heldwein Torsten Bossert Markus Richter Thomas Lehmann Ole Bayer3 Khosro Hekmat1 Abstract Background Outcome prediction scoring systems are increasingly used in intensive care medicine but most were not developed for use in cardiac surgery patients. We compared the performance of four intensive care outcome prediction scoring systems Acute Physiology and Chronic Health Evaluation II APACHE II Simplified Acute Physiology Score II SAPS II Sequential Organ Failure Assessment SOFA and Cardiac Surgery Score CASUS in patients after open heart surgery. Methods We prospectively included all consecutive adult patients who underwent open heart surgery and were admitted to the intensive care unit ICU between January 1st 2007 and December 31st 2008. Scores were calculated daily from ICU admission until discharge. The outcome measure was ICU mortality. The performance of the four scores was assessed by calibration and discrimination statistics. Derived variables Mean- and Max- scores were also evaluated. Results During the study period 2801 patients 29.6 female were included. Mean age was 66.9 10.7 years and the ICU mortality rate was 5.2 . Calibration tests for SOFA and CASUS were reliable throughout p-value not 0.05 but there were significant differences between predicted and observed outcome for SAPS II days 1 2 3 and 5 and APACHE II days 2 and 3 . CASUS and its mean- and maximum-derivatives discriminated better between survivors and non-survivors than the other scores throughout the study area under curve 0.90 . In order of best discrimination CASUS was followed by SOFA then SAPS II and finally APACHE II. SAPS II and APACHE II derivatives had .