Compare the predictive value in postoperative mortality in patients undergoing coronary artery bypass grafting by seven different risk scoring system / 中华胸心血管外科杂志

ABSTRACT

ObjectiveTo access the predictive value in Postoperative mortality in patients undergoing coronary artery bypass grafting(CABG) by seven different Risk scoring system.MethodsTo collect the clinical information of patients undergoing CABG in our department.SinoSCORE,Additive EuroSCORE,Logistic EuroSCORE,OPR,Cleveland model,Parsonnet score,QMMI was used to predict postoperative mortality for all patients,and calculate the mean predictive postoperative mortality.To devided the patients to six groupgroup Ⅰ (0 - 1.99％ ),group Ⅱ (2.00％ - 3.99％ ),group Ⅲ (4.00％ - 5.99％ ),group Ⅳ ( 6.00％ - 7.99％ ),group Ⅴ (8.00％ - 9.99％ ),group Ⅵ ( ＞ 10％ ) by predictive postoperative mortality.Access the performance of risk scoring system predict the mortality through compare the predictive mortality and the observed mortality in different Risk stratification.To use Hosmer-Lemeshow goodness-of-fit test access the calibration.Discrimination was tested by determining the area under the receiver operating characteristic(ROC) curve(AUG).ResultsThe overall mean baseline age was ( 62.8 ± 8.8 ) years.The observed mortality in all our study patients was 1.99 ％ ( 22/1103 cases).The predictive mortality calculated by SinoSCORE,Additive EuroSCORE,Logistic EuroSCORE,OPR,Cleveland model,Parsonnet score and QMMI were 3.01％,4.38％,3.83％,1.69％,4.42％,6.71％ and3.71％.And the most closest is OPR,SinoSCORE,QMMI.Group tests confirmed Logistic EuroSCORE Overestimated the mortality in all the group.Predicted mortality calculated by Additive EuroSCORE was lower than the actual mortality in group Ⅵ and higher than the observed mortality in other group.SinoSCORE、Cleveland model、Parsonnet score、QMMI Overestimated the mortality in all the group expect group Ⅰ.OPR forecast a lower mortality Compared with observed mortality in group Ⅰ and group Ⅳ and a Slightly higher mortality in group Ⅱ,group Ⅲ.To use Hosmer - Lemeshow goodness-of-fit test access the calibration.The text proved all the risk scoring system had a good calibration for postoperative mortality (P ＞ 0.05 ).Discrimination was tested by ROC,only SinoSCORE ( AUC =0.751 ＞ 0.70) showed high discriminatory ability in predicting mortality.ConclusionSinoSCOBE have a good forecast performance for the postoperative mortality in the patients undergoing CABG in our department in seven different Risk scoring system.And SinoSCORE could be used in preoperative risk assessment.