A comparative study of the risk stratification models for pediatric cardiac surgery
Abstract Objective The objective of the study was to compare Risk Assessment for Congenital Heart Surgery (RACHS-1), Aristotle Basic Complexity (ABC) and Society of Thoracic Surgeons – European Association for Cardiothoracic Surgery (STS-EACTS) complexity scoring models for predicting outcome after...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Springer
2018-03-01
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| Series: | Egyptian Journal of Critical Care Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1016/j.ejccm.2018.03.001 |
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| Summary: | Abstract Objective The objective of the study was to compare Risk Assessment for Congenital Heart Surgery (RACHS-1), Aristotle Basic Complexity (ABC) and Society of Thoracic Surgeons – European Association for Cardiothoracic Surgery (STS-EACTS) complexity scoring models for predicting outcome after surgery for congenital heart disease. Methods This retrospective study included children <18 years. Procedures were categorized based on RACHS-1, ABC and STS-EACTS system. Outcome indicators were prolonged length of ICU stay (upper 25th percentile) and hospital mortality. The stratification models were tested for calibration using Hosmer Lemeshow modification of chi-square test and for discrimination using Receiver Operating Characteristic (ROC) curve. Area under the curve (AUC) of individual ROC curves was compared using z-statistics. Results The study included 920 patients. All 3 models showed good fit for both prolonged ICU stay and mortality on calibration. STS-EACTS outclassed RACHS-1 and ABC models with AUC of 0.759 for prolonged PLOS and 0.870 for hospital mortality. AUC of ROC curve for STS-EACTS was significantly higher than RACHS-1 model for both prolonged PLOS (p - 0.046) and hospital mortality (p − 0.015). No significant difference was observed between the AUC of ROC curves of other models. Conclusion Risk stratification for pediatric heart surgery is a useful tool to predict the outcome. STS-EACTS risk stratification model has the best discriminative power. |
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| ISSN: | 2090-7303 2090-9209 |