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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| Format: | Article |
| Language: | English |
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Springer
2018-03-01
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| Series: | Egyptian Journal of Critical Care Medicine |
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| Online Access: | https://doi.org/10.1016/j.ejccm.2018.03.001 |
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| author | Shahzad Alam Akunuri Shalini Rajesh G. Hegde Rufaida Mazahir Akanksha Jain |
| author_facet | Shahzad Alam Akunuri Shalini Rajesh G. Hegde Rufaida Mazahir Akanksha Jain |
| author_sort | Shahzad Alam |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-9741bfeedfef4d26926aaf0a1c4f6cf9 |
| institution | DOAJ |
| issn | 2090-7303 2090-9209 |
| language | English |
| publishDate | 2018-03-01 |
| publisher | Springer |
| record_format | Article |
| series | Egyptian Journal of Critical Care Medicine |
| spelling | doaj-art-9741bfeedfef4d26926aaf0a1c4f6cf92025-08-20T03:04:11ZengSpringerEgyptian Journal of Critical Care Medicine2090-73032090-92092018-03-01615810.1016/j.ejccm.2018.03.001A comparative study of the risk stratification models for pediatric cardiac surgeryShahzad Alam0Akunuri Shalini1Rajesh G. Hegde2Rufaida Mazahir3Akanksha Jain4Pediatric Cardiac ICU, Narayana HrudayalayaPediatric Cardiac ICU, Narayana HrudayalayaPediatric Cardiac ICU, Narayana HrudayalayaDepartment of Pediatric Cardiac Evaluation and Cardiac Surgery unit, Jawaharlal Nehru Medical CollegePediatric Cardiac ICU, Narayana HrudayalayaAbstract 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.https://doi.org/10.1016/j.ejccm.2018.03.001RACHSAristotle Basic Complexity scoreSTS-EACTS scorePediatric cardiac surgeryCardiac ICU |
| spellingShingle | Shahzad Alam Akunuri Shalini Rajesh G. Hegde Rufaida Mazahir Akanksha Jain A comparative study of the risk stratification models for pediatric cardiac surgery Egyptian Journal of Critical Care Medicine RACHS Aristotle Basic Complexity score STS-EACTS score Pediatric cardiac surgery Cardiac ICU |
| title | A comparative study of the risk stratification models for pediatric cardiac surgery |
| title_full | A comparative study of the risk stratification models for pediatric cardiac surgery |
| title_fullStr | A comparative study of the risk stratification models for pediatric cardiac surgery |
| title_full_unstemmed | A comparative study of the risk stratification models for pediatric cardiac surgery |
| title_short | A comparative study of the risk stratification models for pediatric cardiac surgery |
| title_sort | comparative study of the risk stratification models for pediatric cardiac surgery |
| topic | RACHS Aristotle Basic Complexity score STS-EACTS score Pediatric cardiac surgery Cardiac ICU |
| url | https://doi.org/10.1016/j.ejccm.2018.03.001 |
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