PMID- 34343224 OWN - NLM STAT- MEDLINE DCOM- 20211203 LR - 20211214 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 16 IP - 8 DP - 2021 TI - Mortality risk prediction in high-risk patients undergoing coronary artery bypass grafting: Are traditional risk scores accurate? PG - e0255662 LID - 10.1371/journal.pone.0255662 [doi] LID - e0255662 AB - BACKGROUND: The performance of traditional scores is significantly limited to predict mortality in high-risk cardiac surgery. The aim of this study was to compare the performance of STS, ESII and HiriSCORE models in predicting mortality in high-risk patients undergoing CABG. METHODS: Cross-sectional analysis in the international prospective database of high-risk patients: HiriSCORE project. We evaluated 248 patients with STS or ESII (5-10%) undergoing CABG in 8 hospitals in Brazil and China. The main outcome was mortality, defined as all deaths occurred during the hospitalization in which the operation was performed, even after 30 days. Five variables were selected as predictors of mortality in this cohort of patients. The model's performance was evaluated through the calibration-in-the-large and the receiver operating curve (ROC) tests. RESULTS: The mean age was 69.90+/-9.45, with 52.02% being female, 25% of the patients were on New York Heart Association (NYHA) class IV and 49.6% had Canadian Cardiovascular Society (CCS) class 4 angina, and 85.5% had urgency or emergency status. The mortality observed in the sample was 13.31%. The HiriSCORE model showed better calibration (15.0%) compared to ESII (6.6%) and the STS model (2.0%). In the ROC curve, the HiriSCORE model showed better accuracy (ROC = 0.74) than the traditional models STS (ROC = 0.67) and ESII (ROC = 0.50). CONCLUSION: Traditional models were inadequate to predict mortality of high-risk patients undergoing CABG. However, the HiriSCORE model was simple and accurate to predict mortality in high-risk patients. FAU - Goncharov, Maxim AU - Goncharov M AD - Department of Cardiovascular Surgery, Instituto do Coracao, University of Sao Paulo, Sao Paulo, Brazil. FAU - Mejia, Omar Asdrubal Vilca AU - Mejia OAV AUID- ORCID: 0000-0002-1635-4984 AD - Department of Cardiovascular Surgery, Instituto do Coracao, University of Sao Paulo, Sao Paulo, Brazil. AD - Department of Cardiovascular Surgery, Hospital Samaritano Paulista, Sao Paulo, Brazil. FAU - Arthur, Camila Perez de Souza AU - Arthur CPS AD - Department of Cardiovascular Surgery, Beneficencia Portuguesa de Sao Paulo, Sao Paulo, Brazil. FAU - Orlandi, Bianca Maria Maglia AU - Orlandi BMM AUID- ORCID: 0000-0002-4672-6494 AD - Department of Cardiovascular Surgery, Instituto do Coracao, University of Sao Paulo, Sao Paulo, Brazil. FAU - Sousa, Alexandre AU - Sousa A AUID- ORCID: 0000-0002-2310-5310 AD - Department of Cardiovascular Surgery, Beneficencia Portuguesa de Sao Paulo, Sao Paulo, Brazil. FAU - Oliveira, Marco Antonio Praca AU - Oliveira MAP AD - Department of Cardiovascular Surgery, Beneficencia Portuguesa de Sao Paulo, Sao Paulo, Brazil. FAU - Atik, Fernando Antibas AU - Atik FA AD - Department of Cardiovascular Surgery, Instituto de Cardiologia do Distrito Federal, Brasilia, Brazil. FAU - Segalote, Rodrigo Coelho AU - Segalote RC AD - Department of Cardiovascular Surgery, Instituto Nacional de Cardiologia do Rio de Janeiro, Rio de Janeiro, Brazil. FAU - Tiveron, Marcos Gradim AU - Tiveron MG AD - Department of Cardiovascular Surgery, Hospital Santa Casa de Misericordia de Marilia, Marilia, Brazil. FAU - de Barros E Silva, Pedro Gabriel Melo AU - de Barros E Silva PGM AUID- ORCID: 0000-0003-1940-4470 AD - Department of Cardiovascular Surgery, Hospital Samaritano Paulista, Sao Paulo, Brazil. FAU - Nakazone, Marcelo Arruda AU - Nakazone MA AUID- ORCID: 0000-0002-0449-7056 AD - Department of Cardiovascular Surgery, Hospital de Base de Sao Jose do Rio Preto, Sao Jose do Rio Preto, Brazil. FAU - Lisboa, Luiz Augusto Ferreira AU - Lisboa LAF AD - Department of Cardiovascular Surgery, Instituto do Coracao, University of Sao Paulo, Sao Paulo, Brazil. FAU - Dallan, Luis Alberto Oliveira AU - Dallan LAO AD - Department of Cardiovascular Surgery, Instituto do Coracao, University of Sao Paulo, Sao Paulo, Brazil. FAU - Zheng, Zhe AU - Zheng Z AD - Department of Cardiovascular Surgery, Fuwai Hospital, Beijing, China. FAU - Hu, Shengshou AU - Hu S AD - Department of Cardiovascular Surgery, Fuwai Hospital, Beijing, China. FAU - Jatene, Fabio Biscegli AU - Jatene FB AD - Department of Cardiovascular Surgery, Instituto do Coracao, University of Sao Paulo, Sao Paulo, Brazil. LA - eng PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20210803 PL - United States TA - PLoS One JT - PloS one JID - 101285081 SB - IM EIN - PLoS One. 2021 Oct 12;16(10):e0258706. PMID: 34637484 MH - Aged MH - Area Under Curve MH - Brazil/epidemiology MH - China/epidemiology MH - Coronary Artery Bypass/*adverse effects MH - Coronary Artery Disease/epidemiology/*mortality/*surgery MH - Cross-Sectional Studies MH - Databases, Factual MH - Female MH - *Hospital Mortality MH - Humans MH - Male MH - Middle Aged MH - *Models, Statistical MH - Prospective Studies MH - ROC Curve MH - Risk Assessment MH - Risk Factors MH - Treatment Outcome PMC - PMC8330943 COIS- The authors have no conflict of interest to declare in relation to this work. EDAT- 2021/08/04 06:00 MHDA- 2021/12/15 06:00 PMCR- 2021/08/03 CRDT- 2021/08/03 17:24 PHST- 2021/04/13 00:00 [received] PHST- 2021/07/21 00:00 [accepted] PHST- 2021/08/03 17:24 [entrez] PHST- 2021/08/04 06:00 [pubmed] PHST- 2021/12/15 06:00 [medline] PHST- 2021/08/03 00:00 [pmc-release] AID - PONE-D-21-12297 [pii] AID - 10.1371/journal.pone.0255662 [doi] PST - epublish SO - PLoS One. 2021 Aug 3;16(8):e0255662. doi: 10.1371/journal.pone.0255662. eCollection 2021.