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- Title
Validation and quality measurements for STS, EuroSCORE II and a regional risk model in Brazilian patients.
- Authors
Mejia, Omar Asdrúbal Vilca; Borgomoni, Gabrielle Barbosa; Zubelli, Jorge Passamani; Dallan, Luís Roberto Palma; Pomerantzeff, Pablo Maria Alberto; Oliveira, Marco Antonio Praça; Petrucci Junior, Orlando; Tiveron, Marcos Gradim; Nakazone, Marcelo Arruda; Tineli, Rafael Ângelo; Campagnucci, Valquíria Pelisser; Silva, Roberto Rocha e; Rodrigues, Alfredo José; Gomes, Walter José; Lisboa, Luiz Augusto Ferreira; Jatene, Fábio Biscegli
- Abstract
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 São 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.
- Subjects
SAO Paulo (Brazil); NEW York (State); BRAZIL; RHEUMATIC heart disease; TYPE 1 diabetes; CHAGAS' disease; HEART disease diagnosis; CARDIAC surgery; OLDER patients
- Publication
PLoS ONE, 2020, Vol 15, Issue 9, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0238737