Ahmet Barış DURUKAN, Nevriye SALMAN, Elif DURUKAN, Cem YORGANCIOĞLU, Halil İbrahim UÇAR, Hasan Alper GÜRBÜZ

Age, creatinine, ejection fraction score: simpler is easier

Amaç: Bu çalışmada, elektif kalp cerrahisi uygulanan hastalarda, yaş, kreatinin, ejeksiyon fraksiyon (ACEF) skoru ve lojistik Avrupa kalp cerrahisi risk değerlendirme sistemi (EuroSCORE) ile tahmin edilen mortalite oranlarının gözlenen mortalite ile karşılaştırılması amaçlandı.Çalışma planı: Bu retrospektif tek merkezli çalışmaya Ocak 2011 ve Şubat 2013 tarihleri arasında, elektif kalp ameliyatı yapılan ve ACEF skorlarını karşılayan toplam 1044 hastadan 993 hasta (279 kadın; 714 erkek; ort. yaş 61.2±10.5 yıl; dağılım 32-91 yıl) dahil edildi. Gözlenen cerrahi mortalite ve tahmin edilen cerrahi mortalite oranları, ACEF skoru ve lojistik EuroSCORE kullanılarak hesaplandı.Bul gu lar: Gözlenen mortalite oranı %1.70 idi. Hesaplanan ACEF skoru ile tahmin edilen mortalite, gözlenen mortaliteye benzerdi (%2.38; p=0.269); ancak lojistik EuroSCORE ile tahmin edilen mortalite gözlenen mortaliteyi daha fazla hesapladı (%3.26; p=0.021). Bu karşılaştırma analizi, izole koroner arter baypas greft hastaları için tekrarlandığında, her iki sistem de gözlenen mortaliteyi daha yüksek hesapladı (ACEF: %2.45, p=0.009; lojistik EuroSCORE: %2.78; p=0.022; gözlenen mortalite: %1.0).So nuç: Bilgimiz dahilinde, bu Türkiye'den ACEF skoru ile tahmin edilen mortalite sonuçlarını gösteren ilk çalışmadır. Elektif kalp cerrahisi uygulanan hastalarda ACEF skoru ile tahmin edilen mortalite, gözlenen mortaliteye benzerdi; ancak lojistik EuroSCORE ile belirlenen mortalite gözlenen mortaliteyi daha yüksek hesapladı. İzole koroner arter baypas greft cerrahisinde de her iki sistem mortaliteyi yüksek hesapladı.

Yaş, kreatinin, ejeksiyon fraksiyonu skoru: Daha basit olan daha kolaydır

Background: In this study, we compared the age, creatinine, ejection fraction (ACEF) score and logistic European system for cardiac operative risk evaluation (EuroSCORE) predicted mortality rates with observed mortality in patients undergoing elective cardiac surgery. Methods: This retrospective single-center study included 993 (279 females, 714 males; mean age: 61.2±10.5 years; range 32 to 91 years) of a total of 1044 patients who underwent elective cardiac surgery and met ACEF scores between January 2011 and February 2013. The observed operative mortality and predicted operative mortality using the ACEF score and the logistic EuroSCORE were calculated. Results: The observed mortality rate was 1.70%. The calculated ACEF score predicted mortality was similar to the observed mortality (2.38%; p=0.269), whereas the logistic EuroSCORE predicted mortality overestimated the observed mortality (3.26%; p=0.021). The comparison analysis was repeated for isolated coronary artery bypass graft patients in whom both systems overestimated the mortality rate (ACEF: 2.45%, p=0.009; logistic EuroSCORE: 2.78%; p=0.022 vs. observed mortality: 1.0%). Conclusion: To the best of our knowledge, this is the first study documenting the ACEF score predicted mortality results from Turkey. The ACEF score predicted mortality was comparable to the observed mortality in patients undergoing elective cardiac surgery, whereas the logistic EuroSCORE predicted mortality overestimated the observed mortality. In addition, both systems overestimated the mortality in isolated coronary artery bypass graft surgery.

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