İsmail HABERAL, Esra ERTÜRK, Mahmut AKYILDIZ, Tamer AKSOY, Yılmaz ZORMAN, Orhan FINDIK, Mustafa ZENGİN

EuroSCORE, Cleveland ve CABDEAL klinik risk sınıflama sistemlerinin Türk toplumu için duyarlılık ve özgüllüklerinin karşılaştırılması

Amaç: Bu çalışmada üç risk sınıflama sistemi birbiriyle kıyaslanarak Türk toplumu için mortalite ve morbidite oranını öngörmede hangi sistemin daha uygun olduğunun belirlenmesi amaçlandı. Çalışma planı: Bu retrospektif çalışmaya Şubat 2005 ve Aralık 2006 tarihleri arasında kliniğimizde koroner arter baypas greft (KABG) cerrahisi yapılan ardışık 501 hasta (366 erkek, 133 kadın; ort. yaş 63.4±19.4 yıl; dağılım 44-83 yıl) dahil edildi. Cleveland, EuroSCORE ve CABDEAL skorlama sistemlerinde yer alan ameliyat öncesi ve ameliyat sırası risk faktörleri her bir hasta için incelendi ve üç sisteminin duyarlılığı ve özgüllüğü, mortalite ve morbidite açısından kıyaslandı. Bulgular: Mortalite için duyarlılık ve özgüllük, Cleveland sisteminde sırasıyla %61.5 ve %90.4, EuroSCORE sisteminde ise bu oran sırasıyla %92.3 ve %82.2 olarak bulundu. CABDEAL sisteminin duyarlılık ve özgüllükleri ise sırasıyla %92.3 ve %44.9 olarak hesaplandı. Morbidite için ise, duyarlılık ve özgüllük sırasıyla Cleveland sisteminde %23.5 ve %89.5 iken, EuroSCORE sisteminde sırasıyla %41.2 ve %81 idi. CABDEAL sisteminde ise duyarlılık ve özgüllük sırasıyla %82.4 ve %44.8 idi. Sonuç: Bu çalışmanın sonuçları, beklenen mortalite oranlarını belirlemede EuroSCORE sisteminin, beklenen morbidite oranlarını tahminde CABDEAL sisteminin ve daha sonra Cleveland sisteminin kalp hastalığı olan Türk toplumunda daha uygun olduğunu göstermiştir.

A comparision of the sensitivity and specificity of the EuroSCORE, Cleveland, and CABDEAL risk stratification systems in the Turkish population

Background: In this study, we aimed to compare three risk stratification systems to establish which of them is more suitable for predicting mortality and morbidity rates in the Turkish population. Methods: Our retrospective study included 501 consecutive patients (366 males, 135 females; mean age 63.4±19.4 years; range 44 to 83 years) who underwent coronary artery bypass graft (CABG) surgery between February 2005 and December 2006 in our clinic. The preoperative and intraoperative risk factors of the Cleveland, EuroSCORE, and CABDEAL risk stratification systems were analyzed for each patient, and the sensitivity and specificity of these three systems were compared in terms of mortality and morbidity. Results: In terms of mortality, the sensitivity and the specificity of the Cleveland system was found to be 61.5% and 90.4%, respectively while for the EuroSCORE system, the rates were 92.3% and 82.2%, respectively. For the CABDEAL system, the sensitivity and specificity were 92.3% and 44.9%, respectively. In terms of morbidity, the sensitivity and specificity of Cleveland system were 23.5% and 89.5%, respectively, while they were 41.2% and 81%, respectively for the EuroSCORE. The sensitivity and specificity of the CABDEAL system were 82.4% and 44.8%, respectively. Conclusion: The study results showed that the EuroSCORE system is more suitable for predicting the expected mortality rates while the CABDEAL system followed by the Cleveland system are more appropriate in for predicting the expected morbidity rates in the Turkish population with cardiac disease.

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