Risk Stratification Scores for Predicting Mortality in Coronary Artery Bypass Surgery

 

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Introduction

Risk-stratification scores (RSSs) for heart surgery were introduced to estimate the perioperative risk of death during a heart operation or in the postoperative course, and to assess the postoperative risk of complication during the 30-day hospital stay [1] [2]. Available RSSs are based on different patient data and calculate the predicted risk with different algorithms (see below). Most of them were designed for patients undergoing surgery for coronary artery bypass grafting (CABG). Many RSSs are presently in clinical use for different purposes [3]. For quality management in CABG surgery, widespread use of a single RSS would be desirable, as this is a prerequisite for inter-institutional comparison [3] [4].

Therefore, we applied four RSSs - the Cleveland Clinic or Higgins Score (CCS/Higgins) [5], the Euro Score (Euro) [6], the French Score (French) [7] and the Parsonnet Score (Parsonnet) [8] - to patients in our institute who consecutively underwent CABG. The RSSs were tested for validity and practicability. The aim of our study was to determine the RSS most appropriate in clinical practice for the following: Firstly, predicting grouped risk for death; secondly, predicting individual risk for death; and thirdly, expressing the severity of patients' disease when they present for surgery.

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Dr. Rufus Baretti

Deutsches Herzzentrum Berlin

Augustenburger Platz 1

13353 Berlin

Germany

Phone: +49 (30) 4593-1000

Fax: +49 (30) 4593-1003

Email: baretti@dhzb.de