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Myocardial Infarction and Functional Outcome Assessment in Pigs
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Performance of Severity Indices to Estimate Postoperative Complications of Myocardial Revascularization

Silvana Alves Dos Santos Franzotti1, Dyenily Alessi Sloboda1, Juliana Rosendo Silva2

  • 1Universidade de São Paulo - Escola de Enfermagem, São Paulo, SP - Brasil.

Arquivos Brasileiros De Cardiologia
|October 7, 2020
PubMed

Insights

The Acute Physiology and Chronic Health Evaluation (APACHE II) score effectively predicted neurological and renal complications in patients post-Coronary Artery Bypass Grafting (CABG) surgery. However, other severity indices showed limited accuracy for predicting various post-CABG complications.

Area of Science:

  • Cardiology
  • Intensive Care Medicine
  • Medical Informatics

Background:

  • Postoperative myocardial revascularization (Coronary Artery Bypass Grafting - CABG) patients in the intensive care unit (ICU) face risks of complications.
  • Early identification of these risks is crucial for improving patient outcomes and reducing mortality.

Purpose of the Study:

  • To evaluate the predictive performance of established severity indices for complications in post-CABG patients during their ICU stay.

Main Methods:

  • A retrospective cross-sectional study analyzed electronic medical records of 366 adult patients undergoing isolated CABG.
  • The study assessed the accuracy of European System for Cardiac Operative Risk Evaluation (EuroScore), APACHE II, SAPS II, and SOFA using Receiver Operating Characteristic (ROC) curves.

Main Results:

  • The Acute Physiology and Chronic Health Evaluation (APACHE II) index demonstrated satisfactory performance in predicting neurological (AUC 0.72) and renal (AUC 0.78) complications.
  • Identified complications included respiratory (24.32%), cardiovascular (19.95%), neurological (10.38%), hematological (10.38%), infectious (6.56%), and renal (3.55%).

Conclusions:

  • APACHE II is a valuable tool for predicting specific post-CABG complications like neurological and renal issues.
  • The study advises against the indiscriminate use of severity indices for predicting all potential complications in post-CABG patients, highlighting the need for tailored approaches.
Abstract

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