Mehmet ATAY, Burak AÇIKGÖZ, Onur SAYDAM, Ali Aycan KAVALA, Saygın TÜRKYILMAZ, Vedat BAKUY, Mete GÜRSOY, Cabir GÜLMALIYEV, İsmail UNGAN, Ahmet AKGÜL

Koroner bypass cerrahisi geçiren hastalarda 1-yıllık mortaliteyi öngörmede lojistik EuroSCORE, SYNTAX ve EuroSCORE II’nin karşılaştırılması

Amaç: Bu çalışmanın amacı koroner arter bypass greftleme (CABG) operasyonu geçiren hastalarda mortalite açısından uygun skorlama sistemini bulmak amacı ile EuroSCORE II, Lojistik EuroSCORE ve SYNTAX skorlarının karşılaştırılmasıdır.Gereç ve Yöntem: Kliniğimizde CABG cerrahisi geçiren 228 hastanın demografik özellikleri, ekokardiyografik bulguları, operasyon notları ve dosyaları, perfüzyon ve gözlem notları değerlendirildi. Bulgular: Mortaliteyi belirlemek amacıyla SYNTAX skorunun prediktif değeri 27.5’ten (>27.5) büyüktü, lojistik regresyon (LR+) değeri ise 1.5 idi. EuroSCORE II’nin prediktif değeri 1.82’den yüksekti (>1.82) ve LR+ değeri 2.20 idi. EuroSCORE II’nin pozitif prediktif değerinin düşük olmasına rağmen bir yıllık mortalite oranını tahmin etmede yeterli olduğu bulundu. Mortalite oranını değerlendirmede Lojistik EuroSCORE’un prediktif değeri 5.71’den büyüktü (>5.71) ve LR+ değeri 5.13 idi. Lojistik EuroSCORE da bir yillik mortalite oranini tahmin etmede yeterliydi.Sonuç: Çalışmamızda bir yıllık mortaliteyi tahmin etmede Lojistik EuroSCORE en etkin skorlama sistemi olarak bulunmuştur. İdeal kardiyak risk skorlama sistemini bulmak için randomize klinik çalışmalara ihtiyaç olduğu kanısındayız.

Anahtar Kelimeler:

CABG, risk analizi/modelleme, mortalite

Comparison of logistic EuroSCORE, SYNTAX and EuroSCORE II for predicting 1-year mortality in patients underwent coronary bypass surgery

Objectives: EuroSCORE II, logistic EuroSCORE and SYNTAX scores were compared in patients who underwent CABG in order to find the ideal scoring system for mortality.Methods: This retrospective study attempted to examine the preoperative demographic characteristics, echocardiographic findings, operation notes and files, perfusion cards and observation notes of 228 patients who had undergone CABG surgery in our clinic.Results: It was found that predictive point of SYNTAX score was greater than 27.5 (>27.5), the logistic regression (LR +) value was 1.5 in order to determine mortality rate. Predictive value of EuroSCORE II was higher than 1.82 (>1.82) and LR+ value was 2.20. It was found that EuroSCORE II was enough to predict one-year mortality rate although its positive predictive value was low. Predictive value of logistic EuroSCORE was higher than 5.71 (>5.71) and the LR+ value was 5.13 to assess the mortality rate. Logistic EuroSCORE was also sufficient to predict one-year mortality rate.Conclusion: Logistic EuroSCORE was found to be the most effective scoring system in predicting one-year mortality in this study. We conclude that randomized clinical trials need to be performed in order to find an ideal cardiac risk scoring system.

Keywords:

CABG, risk analysis/modelling, mortality,

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