Related Experiment Video

Updated: Apr 4, 2026

Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
10:38

Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies

Published on: January 16, 2019

21.0K

Age, Creatinine and Ejection Fraction Score in Brazil: Comparison with InsCor and the EuroSCORE

Omar Asdrúbal Vilca Mejía1, Bruna La Regina Matrangolo1, David Provenzale Titinger1

  • 1Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.

Arquivos Brasileiros De Cardiologia
|August 28, 2015
PubMed

Insights

The Age, Creatinine and Ejection Fraction (ACEF) Score showed poor accuracy in predicting cardiac surgery mortality, unlike InsCor and EuroSCORE, in a Brazilian study.

Area of Science:

  • Cardiovascular Surgery
  • Medical Informatics
  • Clinical Risk Stratification

Background:

  • Cardiac surgery risk scores are crucial for patient management and outcomes.
  • Neglecting accurate risk prediction can lead to suboptimal patient care.
  • Evaluating existing and novel risk scores is essential in cardiovascular surgery.

Purpose of the Study:

  • To evaluate the predictive performance of the Age, Creatinine and Ejection Fraction (ACEF) Score for mortality in patients undergoing elective coronary artery bypass graft and/or heart valve surgery.
  • To compare the accuracy of the ACEF Score against established scores like InsCor and EuroSCORE.
  • To determine the reliability of the ACEF Score in a Brazilian tertiary care setting.

Main Methods:

  • A prospective cohort study involving 2,565 patients undergoing elective cardiac surgery.
  • Assessment of the ACEF Score's predictive accuracy using correlation, calibration, and discrimination tests.
  • Comparative analysis of ACEF Score performance against InsCor and EuroSCORE.

Main Results:

  • The ACEF Score demonstrated inadequate calibration (p = 0.046) and questionable discrimination (AUC = 0.625).
  • In contrast, InsCor (p = 0.460, AUC = 0.744) and EuroSCORE (p = 0.750, AUC = 0.763) showed adequate calibration and discrimination.
  • Patient stratification revealed varying risk levels across all assessed models.

Conclusions:

  • The ACEF Score, despite its simplicity, was found to be inaccurate for predicting mortality in elective cardiac surgery patients.
  • InsCor and EuroSCORE exhibited superior accuracy and reliability compared to the ACEF Score in this cohort.
  • Findings suggest that the ACEF Score may not be suitable for risk stratification in this specific patient population and setting.
Abstract

More Related Videos

Assessment of Pulmonary Capillary Blood Volume, Membrane Diffusing Capacity, and Intrapulmonary Arteriovenous Anastomoses During Exercise07:09

Assessment of Pulmonary Capillary Blood Volume, Membrane Diffusing Capacity, and Intrapulmonary Arteriovenous Anastomoses During Exercise

Published on: February 20, 2017

13.9K
High-Resolution Cardiac Positron Emission Tomography/Computed Tomography for Small Animals11:09

High-Resolution Cardiac Positron Emission Tomography/Computed Tomography for Small Animals

Published on: December 16, 2022

4.5K

Related Concept Videos

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area.
308
Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance01:25

Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance

In healthy individuals, serum creatinine levels remain stable due to a balance between its constant production—primarily from muscle metabolism—and renal excretion. Creatinine is freely filtered by the glomeruli, making it a valuable marker for estimating renal function. When the glomerular filtration rate (GFR) decreases, the kidneys can only eliminate less creatinine, causing serum levels to rise.Serum creatinine concentration is widely used to estimate creatinine clearance...
349
Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate01:25

Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate

The glomerular filtration rate (GFR) is a critical indicator of kidney health, reflecting how well the kidneys filter blood. Changes in GFR can signal potential kidney impairment, necessitating accurate measurement methods to monitor kidney function effectively.Various molecules can serve as markers for GFR measurement, with the ideal marker meeting several specific criteria. It must freely filter at the glomerulus, avoid reabsorption or secretion by the renal tubules, remain unmetabolized, not...
107
Renal Drug Clearance: Comparison Between Renal Excretion Methods01:08

Renal Drug Clearance: Comparison Between Renal Excretion Methods

Renal clearance is a critical parameter encompassing kidney filtration, secretion, and reabsorption processes. It is calculated using a specific equation to determine the rate at which the kidneys clear a drug.
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...
785
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
549
Serum Studies: Renal Function Tests01:24

Serum Studies: Renal Function Tests

Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.
625