PMID- 32911513 OWN - NLM STAT- MEDLINE DCOM- 20201102 LR - 20201102 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 15 IP - 9 DP - 2020 TI - Validation and quality measurements for STS, EuroSCORE II and a regional risk model in Brazilian patients. PG - e0238737 LID - 10.1371/journal.pone.0238737 [doi] LID - e0238737 AB - OBJECTIVES: The objectives of this study were to describe a novel statewide registry for cardiac surgery in Brazil (REPLICCAR), to compare a regional risk model (SPScore) with EuroSCORE II and STS, and to understand where quality improvement and safety initiatives can be implemented. METHODS: A total of 11 sites in the state of Sao Paulo, Brazil, formed an online registry platform to capture information on risk factors and outcomes after cardiac surgery procedures for all consecutive patients. EuroSCORE II and STS values were calculated for each patient. An SPScore model was designed and compared with EuroSCORE II and STS to predict 30-day outcomes: death, reoperation, readmission, and any morbidity. RESULTS: A total of 5222 patients were enrolled in this study between November 2013 and December 2017. The observed 30-day mortality rate was 7.6%. Most patients were older, overweight, and classified as New York Heart Association (NYHA) functional class III; 14.5% of the patient population had a positive diagnosis of rheumatic heart disease, 10.9% had insulin-dependent diabetes, and 19 individuals had a positive diagnosis of Chagas disease. When evaluating the prediction performance, we found that SPScore outperformed EuroSCORE II and STS in the prediction of mortality (0.90 vs. 0.76 and 0.77), reoperation (0.84 vs. 0.60 and 0.56), readmission (0.84 vs. 0.55 and 0.51), and any morbidity (0.80 vs. 0.65 and 0.64), respectively (p<0.001). CONCLUSIONS: The REPLICCAR registry might stimulate the creation of other cardiac surgery registries in developing countries, ultimately improving the regional quality of care provided to patients. FAU - Mejia, Omar Asdrubal Vilca AU - Mejia OAV AUID- ORCID: 0000-0002-1635-4984 AD - Department of Thoracic and Cardiovascular Surgery, Heart Institute, University of Sao Paulo Medical Center, Sao Paulo, Sao Paulo, Brazil. AD - Department of Cardiovascular Surgery, Hospital Samaritano Paulista, Sao Paulo, Sao Paulo, Brazil. FAU - Borgomoni, Gabrielle Barbosa AU - Borgomoni GB AUID- ORCID: 0000-0002-9243-7407 AD - Department of Thoracic and Cardiovascular Surgery, Heart Institute, University of Sao Paulo Medical Center, Sao Paulo, Sao Paulo, Brazil. FAU - Zubelli, Jorge Passamani AU - Zubelli JP AD - National Institute for Pure and Applied Mathematics, Rio de Janeiro, Rio de Janeiro, Brazil. FAU - Dallan, Luis Roberto Palma AU - Dallan LRP AD - Department of Thoracic and Cardiovascular Surgery, Heart Institute, University of Sao Paulo Medical Center, Sao Paulo, Sao Paulo, Brazil. FAU - Pomerantzeff, Pablo Maria Alberto AU - Pomerantzeff PMA AD - Department of Thoracic and Cardiovascular Surgery, Heart Institute, University of Sao Paulo Medical Center, Sao Paulo, Sao Paulo, Brazil. FAU - Oliveira, Marco Antonio Praca AU - Oliveira MAP AD - Team of Prof. Dr. Sergio Almeida de Oliveira in Hospital Real and Benemerita Sociedade Portuguesa de Beneficencia, Sao Paulo, Sao Paulo, Brazil. FAU - Petrucci Junior, Orlando AU - Petrucci Junior O AD - Department of Surgery, Faculty of Medical Science, State University of Campinas, Campinas, Sao Paulo, Brazil. FAU - Tiveron, Marcos Gradim AU - Tiveron MG AUID- ORCID: 0000-0003-3419-9487 AD - Department of Surgery, Irmandade Santa Casa de Marilia, Marilia, Sao Paulo, Brazil. FAU - Nakazone, Marcelo Arruda AU - Nakazone MA AUID- ORCID: 0000-0002-0449-7056 AD - Department of Cardiology and Cardiovascular Surgery, Hospital de Base de Sao Jose do Rio Preto, Sao Jose do Rio Preto, Sao Paulo, Brazil. FAU - Tineli, Rafael Angelo AU - Tineli RA AD - Department of Surgery, Irmandade Santa Casa de Piracicaba, Piracicaba, Sao Paulo, Brazil. FAU - Campagnucci, Valquiria Pelisser AU - Campagnucci VP AD - Department of Surgery, Irmandade Santa Casa de Sao Paulo, Sao Paulo, Brazil. FAU - Silva, Roberto Rocha E AU - Silva RRE AD - Department of Surgery, Paulo Sacramento Hospital, Jundiai, Sao Paulo, Brazil. FAU - Rodrigues, Alfredo Jose AU - Rodrigues AJ AD - Cardiovascular and Thoracic Surgery Division at Ribeirao Preto Medical School - USP, Ribeirao Preto, Sao Paulo, Brazil. FAU - Gomes, Walter Jose AU - Gomes WJ AD - Cardiovascular Surgery Department of the Federal University of Sao Paulo - Escola Paulista de Medicina, Sao Paulo, Sao Paulo, Brazil. FAU - Lisboa, Luiz Augusto Ferreira AU - Lisboa LAF AD - Department of Thoracic and Cardiovascular Surgery, Heart Institute, University of Sao Paulo Medical Center, Sao Paulo, Sao Paulo, Brazil. FAU - Jatene, Fabio Biscegli AU - Jatene FB AD - Department of Thoracic and Cardiovascular Surgery, Heart Institute, University of Sao Paulo Medical Center, Sao Paulo, Sao Paulo, Brazil. CN - REPLICCAR Study Group LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Validation Study DEP - 20200910 PL - United States TA - PLoS One JT - PloS one JID - 101285081 SB - IM MH - Brazil MH - Cardiac Surgical Procedures/adverse effects/*statistics & numerical data MH - Female MH - Humans MH - Male MH - Middle Aged MH - *Models, Statistical MH - Quality Control MH - Registries MH - Risk Assessment MH - Safety PMC - PMC7482975 COIS- The authors have declared that no competing interests exist. EDAT- 2020/09/11 06:00 MHDA- 2020/11/03 06:00 PMCR- 2020/09/10 CRDT- 2020/09/10 20:22 PHST- 2020/05/16 00:00 [received] PHST- 2020/08/22 00:00 [accepted] PHST- 2020/09/10 20:22 [entrez] PHST- 2020/09/11 06:00 [pubmed] PHST- 2020/11/03 06:00 [medline] PHST- 2020/09/10 00:00 [pmc-release] AID - PONE-D-20-14642 [pii] AID - 10.1371/journal.pone.0238737 [doi] PST - epublish SO - PLoS One. 2020 Sep 10;15(9):e0238737. doi: 10.1371/journal.pone.0238737. eCollection 2020.