Characterization and risk prediction of cardiovascular surgeries with cardiopulmonary bypass: a cross-sectional study
Introduction: Cardiovascular surgery risk prediction models are widely applied in medical practice. However, they have been criticized for their low methodological quality and scarce external validation. An additional limitation added in Latin America is that most of these models have been developed...
| Autores principales: | , , , , , |
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| Formato: | Artículo revista |
| Lenguaje: | Español |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2024
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/42432 |
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I10-R327-article-42432 |
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ojs |
| institution |
Universidad Nacional de Córdoba |
| institution_str |
I-10 |
| repository_str |
R-327 |
| container_title_str |
Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Español |
| format |
Artículo revista |
| topic |
cardiovascular surgical procedures risk evaluation and mitigation validation study procedimientos quirúrgicos cardiovasculares evaluación y mitigación de riesgos estudio de validación procedimentos cirúrgicos cardiovasculares avaliação de risco e mitigação estudo de validação |
| spellingShingle |
cardiovascular surgical procedures risk evaluation and mitigation validation study procedimientos quirúrgicos cardiovasculares evaluación y mitigación de riesgos estudio de validación procedimentos cirúrgicos cardiovasculares avaliação de risco e mitigação estudo de validação Politi, Maria Teresa Di Benedetto, Sarah Ferreyra, Raúl Bortman, Guillermo Piazza, Antonio Capurro, Claudia Characterization and risk prediction of cardiovascular surgeries with cardiopulmonary bypass: a cross-sectional study |
| topic_facet |
cardiovascular surgical procedures risk evaluation and mitigation validation study procedimientos quirúrgicos cardiovasculares evaluación y mitigación de riesgos estudio de validación procedimentos cirúrgicos cardiovasculares avaliação de risco e mitigação estudo de validação |
| author |
Politi, Maria Teresa Di Benedetto, Sarah Ferreyra, Raúl Bortman, Guillermo Piazza, Antonio Capurro, Claudia |
| author_facet |
Politi, Maria Teresa Di Benedetto, Sarah Ferreyra, Raúl Bortman, Guillermo Piazza, Antonio Capurro, Claudia |
| author_sort |
Politi, Maria Teresa |
| title |
Characterization and risk prediction of cardiovascular surgeries with cardiopulmonary bypass: a cross-sectional study |
| title_short |
Characterization and risk prediction of cardiovascular surgeries with cardiopulmonary bypass: a cross-sectional study |
| title_full |
Characterization and risk prediction of cardiovascular surgeries with cardiopulmonary bypass: a cross-sectional study |
| title_fullStr |
Characterization and risk prediction of cardiovascular surgeries with cardiopulmonary bypass: a cross-sectional study |
| title_full_unstemmed |
Characterization and risk prediction of cardiovascular surgeries with cardiopulmonary bypass: a cross-sectional study |
| title_sort |
characterization and risk prediction of cardiovascular surgeries with cardiopulmonary bypass: a cross-sectional study |
| description |
Introduction: Cardiovascular surgery risk prediction models are widely applied in medical practice. However, they have been criticized for their low methodological quality and scarce external validation. An additional limitation added in Latin America is that most of these models have been developed in the United States or Europe, which present marked geographical differences. The objective of this study is to characterize the postoperative clinical events of cardiovascular surgeries with the use of cardiopulmonary bypass pump in a local setting and to evaluate the prediction of postoperative mortality using the EuroSCORE II predictive model.
Methods: Cross-sectional study in an urban university hospital in Buenos Aires. Patients ≥21 years of age were included, with a clinical indication for on-pump cardiovascular surgery. Patients with incomplete clinical data regarding EuroSCORE II variables or in-hospital survival, ≥95 years of age, or undergoing heart transplantation were excluded.
Results: 195 patients were enrolled. Postoperative mortality estimated by EuroSCORE II presented a clear underestimation of risk (3.0% vs 7.7%). Discrimination (AUC = 0.82; 95% CI 0.74-0.92) and goodness of fit of the model were adequate (χ2 = 7.91; p = 0.4418). The most frequent postoperative complications were postoperative heart failure (35.9%), vasoplegic shock (13.3%), and cardiogenic shock (10.26%).
Conclusion: The EuroSCORE II is an appropriate tool to discriminate between different risk categories in patients undergoing on-pump cardiovascular surgery, although it underestimates the risk. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2024 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/42432 |
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I10-R327-article-424322024-06-28T16:35:48Z Characterization and risk prediction of cardiovascular surgeries with cardiopulmonary bypass: a cross-sectional study Caracterización y predicción del riesgo de cirugías cardiovasculares con uso de bomba de circulación extracorpórea: un estudio de corte transversal Caracterização e predição do risco de cirurgias cardiovasculares com uso de bomba de circulação extracorpórea: um estudo transversal Politi, Maria Teresa Di Benedetto, Sarah Ferreyra, Raúl Bortman, Guillermo Piazza, Antonio Capurro, Claudia cardiovascular surgical procedures risk evaluation and mitigation validation study procedimientos quirúrgicos cardiovasculares evaluación y mitigación de riesgos estudio de validación procedimentos cirúrgicos cardiovasculares avaliação de risco e mitigação estudo de validação Introduction: Cardiovascular surgery risk prediction models are widely applied in medical practice. However, they have been criticized for their low methodological quality and scarce external validation. An additional limitation added in Latin America is that most of these models have been developed in the United States or Europe, which present marked geographical differences. The objective of this study is to characterize the postoperative clinical events of cardiovascular surgeries with the use of cardiopulmonary bypass pump in a local setting and to evaluate the prediction of postoperative mortality using the EuroSCORE II predictive model. Methods: Cross-sectional study in an urban university hospital in Buenos Aires. Patients ≥21 years of age were included, with a clinical indication for on-pump cardiovascular surgery. Patients with incomplete clinical data regarding EuroSCORE II variables or in-hospital survival, ≥95 years of age, or undergoing heart transplantation were excluded. Results: 195 patients were enrolled. Postoperative mortality estimated by EuroSCORE II presented a clear underestimation of risk (3.0% vs 7.7%). Discrimination (AUC = 0.82; 95% CI 0.74-0.92) and goodness of fit of the model were adequate (χ2 = 7.91; p = 0.4418). The most frequent postoperative complications were postoperative heart failure (35.9%), vasoplegic shock (13.3%), and cardiogenic shock (10.26%). Conclusion: The EuroSCORE II is an appropriate tool to discriminate between different risk categories in patients undergoing on-pump cardiovascular surgery, although it underestimates the risk. Introducción: Los modelos de predicción de riesgo de cirugías cardiovasculares se aplican ampliamente a la práctica médica. Sin embargo, han sido criticados por su baja calidad metodológica y escasa validación externa. En América Latina se agrega la limitación de que la mayoría de estos modelos fueron desarrollados en Estados Unidos o Europa, existiendo diferencias geográficas marcadas. El objetivo de este estudio es caracterizar los eventos clínicos postoperatorios de cirugías cardiovasculares con uso de bomba de circulación extracorpórea en un escenario local y evaluar la predicción de mortalidad postoperatoria del modelo predictivo EuroSCORE II. Métodos: Corte transversal en un hospital universitario urbano de Buenos Aires. Se incluyeron a pacientes ≥21 años de edad, con indicación de cirugía cardiovascular con uso de bomba. Se excluyeron a pacientes con datos clínicos incompletos respecto a las variables del EuroSCORE II o respecto a la sobrevida intrahospitalaria, con ≥95 años de edad o sometidos a trasplante cardíaco. Resultados: Se enrolaron 195 pacientes. La mortalidad postoperatoria estimada por el EuroSCORE II presentó una clara subestimación del riesgo (3,0% vs 7,7%). La discriminación (AUC = 0,82; IC95% 0,74-0,92) y la bondad del ajuste del modelo fueron adecuadas (χ2 = 7,91; p = 0,4418). Las complicaciones postoperatorias más frecuentes fueron insuficiencia cardíaca postoperatoria (35,9%), shock vasopléjico (13,3%) y shock cardiogénico (10,26%). Conclusión: El EuroSCORE II es una herramienta apropiada para discriminar entre diferentes categorías de riesgo en pacientes sometidos a cirugías cardiovasculares con uso de bomba, si bien subestima el riesgo. Introdução: Modelos de predição de risco em cirurgia cardiovascular são amplamente aplicados na prática médica. No entanto, eles foram criticados por sua baixa qualidade metodológica e escassa validação externa. Na América Latina, acrescenta-se a limitação de que a maioria desses modelos foi desenvolvida nos Estados Unidos ou na Europa, com diferenças geográficas marcantes. O objetivo deste estudo é caracterizar os eventos clínicos pós-operatórios de cirurgias cardiovasculares com uso de bomba de circulação extracorpórea em ambiente local e avaliar a predição de mortalidade pós-operatória do modelo preditivo EuroSCORE II. Métodos: Corte transversal em um hospital universitário urbano de Buenos Aires. Foram incluídos pacientes com idade ≥21 anos, com indicação de cirurgia cardiovascular com uso de bomba. Pacientes com dados clínicos incompletos em relação às variáveis do EuroSCORE II ou sobrevida hospitalar, ≥95 anos de idade ou submetidos a transplante cardíaco foram excluídos. Resultados: 195 pacientes foram incluídos. A mortalidade pós-operatória estimada pelo EuroSCORE II apresentou clara subestimação do risco (3,0% vs 7,7%). A discriminação (AUC = 0,82; IC 95% 0,74-0,92) e a qualidade do ajuste do modelo foram adequadas (χ2 = 7,91; p = 0,4418). As complicações pós-operatórias mais frequentes foram insuficiência cardíaca pós-operatória (35,9%), choque vasoplégico (13,3%) e choque cardiogênico (10,26%). Conclusão: O EuroSCORE II é uma ferramenta adequada para discriminar as diferentes categorias de risco em pacientes submetidos à cirurgia cardiovascular com CEC, embora subestime o risco. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2024-06-28 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion text/html application/pdf application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/42432 10.31053/1853.0605.v81.n2.42432 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 81 No. 2 (2024); 233-253 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 81 Núm. 2 (2024); 233-253 Revista da Faculdade de Ciências Médicas de Córdoba; v. 81 n. 2 (2024); 233-253 1853-0605 0014-6722 10.31053/1853.0605.v81.n2 spa https://revistas.unc.edu.ar/index.php/med/article/view/42432/45060 https://revistas.unc.edu.ar/index.php/med/article/view/42432/45070 https://revistas.unc.edu.ar/index.php/med/article/view/42432/45431 Derechos de autor 2024 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0 |