A score proposal to evaluate surgical risk in patients submitted to myocardial revascularization surgery

Scores to predict surgical risk in patients submitted to myocardial revascularization surgery are broadly used.

To develop a score capable to predict mortality in patients submitted to myocardial revascularization surgery.

From January 1996 to December 2007, data were collected from 2809 patients submitted to myocardial revascularization surgery at PUC-RS São Lucas Hospital. In 2/3 of the sample (n = 1875), the score was developed, after uni and mutivariated analyses. In the remaining 1/3 (n = 934) the score was validated. The final score was developed with the total sample, using the same variables (n = 2809). The accuracy of the model was tested using the area under the ROC curve.

The mean age was 61.3 ± 10.1 years and 34% were women. The risk factors identified as independent predictors of surgical mortality and used for score development (parentheses) were: age > 60 years (2), female (2), extracardiac vasculopathy (2), heart failure functional class III and IV (3), ejection fraction<45% (2), atrial fibrillation (2), chronic obstructive pulmonary disease (3), aortic stenosis (3), creatinine 1.5-2.4 (2), creatinine > 2.5 or dialysis (4), emergency/urgency surgery (16). The area obtained under the ROC curve was 0.86 (CI 0.81-0.9).

The score developed, using clinical variables easy to obtain (age, sex, extracardiac vasculopathy, functional class, ejection fraction, atrial fibrillation, chronic obstructive pulmonary disease, aortic stenosis, creatinine and emergency/urgency surgery) showed capability to predict mortality in patients submitted to myocardial revascularization surgery in our Hospital.