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Three Risk Scores For Mortality Prediction In Minimally Invasive Cardiac Surgery

By Rafik Margaryan, Giacomo Bianchi, Giovanni Concistre, Tommaso Gasbarri, Enkel Kallushi, Pierandrea Farneti, Marco Solinas

Posted 05 Jun 2020
medRxiv DOI: 10.1101/2020.06.03.20120949

Objective The Society of Thoracic Surgeons score performance relative to other scores in minimally invasive cardiac surgery is not known. Methods Patients who underwent surgery from 2003 to 2018 identified from database. Additional variables included for STS score calculation, EuroSCORE II and age, creatinine and ejection fraction score calculation. Results A total of 4751 patients were identified from main database. There were actual 47 (0.99%) hospitals deaths. The mean STS score predicted mortality were 2.0 +/- 2.1. Discriminatory power was uniformly good (for STS Mortality: area under curve, 0.86; 95% confidence interval, 0.81 - 0.91). The mean EuroSCORE II predicted mortality were 2.9 +/- 3.8. Discriminatory power was uniformly good similar to that of STS (for EuroSCORE II Mortality: area under curve, 0.9; 95% confidence interval, 0.86 - 0.93). The mean ACEF predicted mortality were 2.5 +/- 2.3. Discriminatory power was uniformly good but inferior to that of STS and EuroSCORE II (for ACEF Mortality: area under curve, 0.72; 95% confidence interval, 0.65 - 0.8). Calibration pattern for STS score was the best for of mortality prediction (p < 0.01), EuroSCORE II and ACEF were constantly overestimating mortality (respectively, p < 0.01 and p < 0.01). scores. Conclusions The STS score has acceptable discrimination power for this sub-population. However, it is not calibrated for the the subset. EuroSCORE II is has good discrimination power, but not calibrate for the this subset of patients. ACEF score had similar performance to EuroSCORE. No algorithm seems suitable for accurate risk estimation.

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