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Published on: March 27, 2018
Sequential organ failure assessment score predicts mortality after coronary artery bypass grafting
Chih-Hsiang Chang1,2, Shao-Wei Chen3,2, Pei-Chun Fan1,2
1Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.
Insights
The Sequential Organ Failure Assessment (SOFA) score accurately predicts in-hospital mortality after coronary artery bypass grafting (CABG). Cardiac and renal SOFA components were key predictors, with SOFA identified as an independent risk factor.
Area of Science:
- Cardiology
- Critical Care Medicine
- Surgical Outcomes Research
Background:
- Coronary artery bypass grafting (CABG) mortality is influenced by factors often missed by current preoperative models.
- Sequential Organ Failure Assessment (SOFA) and APACHE II scores are standard for intensive care unit outcome prediction.
- Existing models may not fully capture risks specific to CABG patients.
Purpose of the Study:
- To evaluate the predictive accuracy of SOFA and APACHE II scores for mortality in patients undergoing isolated CABG.
- To identify specific organ system contributions within the SOFA score to CABG mortality.
- To determine if SOFA or APACHE II scores are independent predictors of mortality post-CABG.
Main Methods:
- A cohort of 483 patients undergoing isolated CABG between January 2010 and April 2013 was analyzed.
- Clinical data, outcomes, and prognostic scores (SOFA, APACHE II) were collected for all participants.
- Model discrimination was assessed using the area under the receiver operating characteristic curve (AUC).
Main Results:
- Both SOFA and APACHE II scores demonstrated effectiveness in predicting in-hospital mortality following CABG.
- Within the SOFA score, cardiac and renal system assessments were the most significant predictors of mortality.
- Multivariate analysis confirmed the SOFA score as the sole independent risk factor for mortality.
Conclusions:
- The SOFA score provides accurate prediction of mortality risk in patients after isolated CABG.
- Specific SOFA components, particularly cardiac and renal, are crucial for risk stratification in this population.
- SOFA score serves as a valuable tool for identifying patients at higher risk of mortality post-CABG.
Background:
Mortality after coronary artery bypass grafting (CABG) is generally associated with underlying disease and surgical factors overlooked in preoperative prognostic models. Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE II) scores are widely used in intensive care units for outcome prediction. This study investigated the accuracy of these models in predicting mortality.
Methods:
Between January 2010 and April 2013, 483 patients who underwent isolated CABG were enrolled. The clinical characteristics, outcomes, and prognostic model scores of the patients were collected. Discrimination was assessed using the area under the curve approach.
Results:
Both SOFA and APACHE II scores were effective for predicting in-hospital mortality. Among the organ systems examined in the SOFA, the cardiac and renal systems were the strongest predictors of CABG mortality. Multivariate analysis identified only the SOFA score as being an independent risk factor for mortality.
Conclusion:
In summary, the SOFA score can be used to accurately identify mortality after isolated CABG.
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