Yıl 2015,
Cilt: 42 Sayı: 1, 55 - 60, 09.05.2015
Öz
Objective: To compare the feasibility of the EuroSCORE and The Society of Thoracic Surgeons risk scoring systems for predicting the surgical mortality of isolated coronary artery bypass surgery patients. Methods: The risk scoring of 148 patients who were operated on between April 2005 and March 2009 was performed prospectively according to the EuroSCORE and STS risk scoring systems. The predicted and observed mortality rates according to each scoring system were compared. Results: Hospital mortality was 13.2% (24 patients). The predicted mortality rate according to EuroSCORE was 4.71±4.9%, whereas it was 1.17±1.35% for STS. There were no significant differences between predicted and observed mortality rates according to either scoring system. The area under the ROC curve was 0.712 for EuroSCORE and was 0.727 for STS. Conclusion: Both scoring systems were efficient for predicting mortality rates for our study. It is an advantage of STS that it also gives valuable information about morbidity but for our not found satisfactory. In conclusion new risks scores for our country’s population are needed
Anahtar Kelimeler
Kaynakça
- Ferraris V, Edwards F, Shahian D, Ferraris S. Risk Stratification
- and Comorbidity. Cohn LH, ed. Cardiac Surgery in the
- Adult. New York: McGraw-Hill, 2008;199-246.
- Parsonnet V, Dean D, Bernstein AD. A method of uniform
- stratification of risk factor evaluating the results of surgery
- in acquired adult heart disease. Circulation. 1989;79:3-12.
- Higgins TL, Estafanous FG, Loop FD, et al. Stratification
- of morbidity and mortality outcome by preoperative risk
- factors in coronary artery bypass patients. J Am Med Assoc
- ;267:2344-48.
- Geissler HJ, Hölzl P, Sacha M, et al. Risk stratification in
- heart surgery: Comparison of six score systems. Eur J Cardiothorac
- Surg. 2000;17:400-6.
- Hamulu A, Özbaran M, Atay Y, Posacıoğlu H. Koroner Bypass
- Ameliyatında Mortalite ve Morbiditeye Etki Eden
- Risk Faktörlerinin Belirlenmesi ve Değerlendirilmesi. Türk
- Göğüs Kalp Damar Cer Derg 1995;3:245-52.
- Nashef SAM, Roques F, Michel P, et al. European system
- for cardiac operative risk evaluation (EuroSCORE). Eur J
- Cardiothorac Surg 1999;16:9-13.
- Okutan H, Yavuz T, Peker O, et al. Kliniğimizde ameliyat
- olan hastalarda Euroscore (European System for Cardiac
- Operative Risk Evaluation) risk skorlama sistemine göre
- sonuçlar. Türk Göğüs Kalp Damar Cer Derg 2002;10:201-5.
- Kaplan M, Kut MS, Çimen S, Demirtaş MM. EuroSCORE
- (European System for Cardiac Operative Risk Evaluation)
- risk skorlama sisteminin ülkemiz hasta profilinde uygulanabilirliğinin
- araştırılması. Türk Göğüs Kalp Damar Cer
- Derg 2003;11:147-58.
- Soyal T, Özeren M, Kar M, et al. Koroner arter bypass reoperasyon
- adaylarında mortalite ve morbiditenin EuroSCORE
- ile retrospektif analizi. Türk Göğüs Kalp Damar Cer Derg
- ;12:241-5.
- Clark RE. The Society of Thoracic Surgeons National Database
- status report. Ann Thorac Surg 1994;57:20-6.
- Shroyer ALW, Coombs LP, Peterson ED, et al. The Society
- of Thoracic Surgeons: 30-Day Operative Mortality and
- Morbidity Risk Models. Ann Thorac Surg 2003;75:1856-
- -
- Acinapura AJ, Jacobowitz IJ, Kramer MD, et al. Demographic
- changes in coronary artery bypass surgery and its
- effect on mortality and morbidity. Eur J Cardiothorac Surg
- ;4:175-81.
- Ivanov J, Weisel RD, David TE, Naylor CD. Fifteen-year
- trends in risk severity and operative mortality in elderly
- patients undergoing coronary artery bypass graft surgery.
- Circulation 1998;97:673-80.
- McGrath LB, Laub GW, Graf D, Gonzalez-Lavin L. Hospital
- death on a cardiac surgical service: negative influence of
- chang ing practice patterns. Ann Thorac Surg 1990;49:410-
- -
- Baker DW, Jones R, Hodges J, et al. Management of heart
- failure, III: the role of revascularization in the treatment of
- patients with moderate or severe left ventricular systolic
- dysfunction. JAMA 1994;272:1528-34.
- Varnauskas E. Twelve-year follow-up of survival in the randomized
- European Coronary Surgery Study. N Engl J Med
- ;319:332-7.
- Yusuf S, Zucker D, Peduzzi P, et al. Effect of coronary
- artery bypass graft surgery on survival: overview of 10-
- year results from randomised trials by the Coronary Artery
- Bypass Graft Surgery Trialists Collaboration. Lancet
- ;344:563-70.
- Rogers WJ, Coggin CJ, Gersh BJ, et al. Ten-year follow-up
- of quality of life in patients randomized to receive medical
- therapy or coronary artery bypass graft surgery. The Coronary
- Artery Surgery Study (CASS). Circulation 1990; 82:
- -58.
- Caracciolo EA, Davis KB, Sopko G, et al. Comparison of
- surgical and medical group survival in patients with left
- main equivalent coronary artery disease: long-term CASS
- experience. Circulation 1995;91:2335-44.
- Chaitman BR, Fisher LD, Bourassa MG, et al. Effect of
- coronary bypass surgery on survival patterns in subsets of
- patients with left main coronary artery disease: report of the
- Collaborative Study in Coronary Artery Surgery (CASS).
- Am J Cardiol 1981;48:765-77.
- Wijeysundera DN, Beattie WS, Djaiani G, et al. Cusimano
- Off-Pump Coronary Artery Surgery for Reducing Mortality
- and Morbidity: Meta-Analysis of Randomized and Observational
- Studies J. Am. Coll. Cardiol. 2005;46:872-82.
- Vanagas G, Kinduris1 Š, Leveckytė A. Comparison of various
- score systems for risk stratification in heart surgery.
- Medıcına 2003;39:739-44.
- Mandel M, Simchen ES, Gurevich YZ. Does the EuroSCORE
- perform well on the STS population? Eur J Cardiothoracic
- Surg 2003;24:334-7.
- Zheng Z, Li Y, Zhang S, Hu S. The Chinese Coronary Artery
- Bypass Grafting Registry Study: how well does the
- EuroSCORE predict operative risk for Chinese population.
- Eur J Cardio-thoracic Surg 2009;35:54-61.
- Karabulut H,Toraman F, Dağdelen S, ve ark. EuroSCORE
- (European System for Cardiac Operative Risk Evaluation)
- Risk Skorlama Sistemi Gerçekçi mi? Türk Kardiyol Dern
- Arş 2001;29:364-67.
- Kandemir Ö, Büyükateş M, Turan SA, ve ark. Koroner Bypass
- Cerrahisinde EuroSCORE VE STS (The Socıety Of
- Thoracıc Surgeons) Risk Skorlama Yöntemlerinin Karşı-
- laştırılması. Türk Göğüs Kalp Damar Cer Derg 2007;18:78-
- -
Aortokoroner bypass cerrahisi uygulanan olgularda EuroSCORE ve STS risk parametrelerinin karşılaştırılması
Öz
Amaç: Bu çalışmada izole koroner bypass olgularında operatif mortaliteyi öngörmede EuroSCORE ve STS risk belirleme sistemlerinin klinik uygulanabilirliğinin karşılaş- tırılması amaçlandı. Yöntemler: Nisan 2005-Mart 2009 tarihleri arasında opere edilen 182 izole koroner bypass olgusunun tüm risk faktörleri, EuroSCORE ve STS risk belirleme sistemlerine göre prospektif olarak kaydedildi. Öngörülen ve gerçekleşen mortalite oranları her risk skoru sistemi için karşı- laştırıldı. Bulgular: Operatif mortalite, 24 hasta ile %13,2 olarak bulundu. EuroSCORE için beklenen mortalite %4,71±4,9 iken STS için bu oran %1,17±1,35 idi. Beklenen ve ger- çekleşen mortalite oranları arasında fark bulunamadı. EuroSCORE için ROC Curve altında kalan alan 0,712, STS için 0,727 olarak hesaplandı. Sonuç: Her iki sistemde mortaliteyi öngörme kuvveti açı- sından, çalışmamızda yeterli olarak bulunmuştur. STS’nin operatif mortalite yanında oluşabilecek morbidite hakkında da bilgi vermesi ek bir avantaj olarak görülebilmesine rağmen çalışmamızda yeterli bulunmamıştır. Sonuç olarak ülkemiz popülasyonu için yeni risk skorlarına ihtiyaç vardır. Anahtar kelimeler: Aortokoroner bypas, cerrahi, STS, EuroSCORE, risk
Anahtar Kelimeler
Kaynakça
- Ferraris V, Edwards F, Shahian D, Ferraris S. Risk Stratification
- and Comorbidity. Cohn LH, ed. Cardiac Surgery in the
- Adult. New York: McGraw-Hill, 2008;199-246.
- Parsonnet V, Dean D, Bernstein AD. A method of uniform
- stratification of risk factor evaluating the results of surgery
- in acquired adult heart disease. Circulation. 1989;79:3-12.
- Higgins TL, Estafanous FG, Loop FD, et al. Stratification
- of morbidity and mortality outcome by preoperative risk
- factors in coronary artery bypass patients. J Am Med Assoc
- ;267:2344-48.
- Geissler HJ, Hölzl P, Sacha M, et al. Risk stratification in
- heart surgery: Comparison of six score systems. Eur J Cardiothorac
- Surg. 2000;17:400-6.
- Hamulu A, Özbaran M, Atay Y, Posacıoğlu H. Koroner Bypass
- Ameliyatında Mortalite ve Morbiditeye Etki Eden
- Risk Faktörlerinin Belirlenmesi ve Değerlendirilmesi. Türk
- Göğüs Kalp Damar Cer Derg 1995;3:245-52.
- Nashef SAM, Roques F, Michel P, et al. European system
- for cardiac operative risk evaluation (EuroSCORE). Eur J
- Cardiothorac Surg 1999;16:9-13.
- Okutan H, Yavuz T, Peker O, et al. Kliniğimizde ameliyat
- olan hastalarda Euroscore (European System for Cardiac
- Operative Risk Evaluation) risk skorlama sistemine göre
- sonuçlar. Türk Göğüs Kalp Damar Cer Derg 2002;10:201-5.
- Kaplan M, Kut MS, Çimen S, Demirtaş MM. EuroSCORE
- (European System for Cardiac Operative Risk Evaluation)
- risk skorlama sisteminin ülkemiz hasta profilinde uygulanabilirliğinin
- araştırılması. Türk Göğüs Kalp Damar Cer
- Derg 2003;11:147-58.
- Soyal T, Özeren M, Kar M, et al. Koroner arter bypass reoperasyon
- adaylarında mortalite ve morbiditenin EuroSCORE
- ile retrospektif analizi. Türk Göğüs Kalp Damar Cer Derg
- ;12:241-5.
- Clark RE. The Society of Thoracic Surgeons National Database
- status report. Ann Thorac Surg 1994;57:20-6.
- Shroyer ALW, Coombs LP, Peterson ED, et al. The Society
- of Thoracic Surgeons: 30-Day Operative Mortality and
- Morbidity Risk Models. Ann Thorac Surg 2003;75:1856-
- -
- Acinapura AJ, Jacobowitz IJ, Kramer MD, et al. Demographic
- changes in coronary artery bypass surgery and its
- effect on mortality and morbidity. Eur J Cardiothorac Surg
- ;4:175-81.
- Ivanov J, Weisel RD, David TE, Naylor CD. Fifteen-year
- trends in risk severity and operative mortality in elderly
- patients undergoing coronary artery bypass graft surgery.
- Circulation 1998;97:673-80.
- McGrath LB, Laub GW, Graf D, Gonzalez-Lavin L. Hospital
- death on a cardiac surgical service: negative influence of
- chang ing practice patterns. Ann Thorac Surg 1990;49:410-
- -
- Baker DW, Jones R, Hodges J, et al. Management of heart
- failure, III: the role of revascularization in the treatment of
- patients with moderate or severe left ventricular systolic
- dysfunction. JAMA 1994;272:1528-34.
- Varnauskas E. Twelve-year follow-up of survival in the randomized
- European Coronary Surgery Study. N Engl J Med
- ;319:332-7.
- Yusuf S, Zucker D, Peduzzi P, et al. Effect of coronary
- artery bypass graft surgery on survival: overview of 10-
- year results from randomised trials by the Coronary Artery
- Bypass Graft Surgery Trialists Collaboration. Lancet
- ;344:563-70.
- Rogers WJ, Coggin CJ, Gersh BJ, et al. Ten-year follow-up
- of quality of life in patients randomized to receive medical
- therapy or coronary artery bypass graft surgery. The Coronary
- Artery Surgery Study (CASS). Circulation 1990; 82:
- -58.
- Caracciolo EA, Davis KB, Sopko G, et al. Comparison of
- surgical and medical group survival in patients with left
- main equivalent coronary artery disease: long-term CASS
- experience. Circulation 1995;91:2335-44.
- Chaitman BR, Fisher LD, Bourassa MG, et al. Effect of
- coronary bypass surgery on survival patterns in subsets of
- patients with left main coronary artery disease: report of the
- Collaborative Study in Coronary Artery Surgery (CASS).
- Am J Cardiol 1981;48:765-77.
- Wijeysundera DN, Beattie WS, Djaiani G, et al. Cusimano
- Off-Pump Coronary Artery Surgery for Reducing Mortality
- and Morbidity: Meta-Analysis of Randomized and Observational
- Studies J. Am. Coll. Cardiol. 2005;46:872-82.
- Vanagas G, Kinduris1 Š, Leveckytė A. Comparison of various
- score systems for risk stratification in heart surgery.
- Medıcına 2003;39:739-44.
- Mandel M, Simchen ES, Gurevich YZ. Does the EuroSCORE
- perform well on the STS population? Eur J Cardiothoracic
- Surg 2003;24:334-7.
- Zheng Z, Li Y, Zhang S, Hu S. The Chinese Coronary Artery
- Bypass Grafting Registry Study: how well does the
- EuroSCORE predict operative risk for Chinese population.
- Eur J Cardio-thoracic Surg 2009;35:54-61.
- Karabulut H,Toraman F, Dağdelen S, ve ark. EuroSCORE
- (European System for Cardiac Operative Risk Evaluation)
- Risk Skorlama Sistemi Gerçekçi mi? Türk Kardiyol Dern
- Arş 2001;29:364-67.
- Kandemir Ö, Büyükateş M, Turan SA, ve ark. Koroner Bypass
- Cerrahisinde EuroSCORE VE STS (The Socıety Of
- Thoracıc Surgeons) Risk Skorlama Yöntemlerinin Karşı-
- laştırılması. Türk Göğüs Kalp Damar Cer Derg 2007;18:78-
- -
Toplam 100 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 9 Mayıs 2015 |
| Gönderilme Tarihi | 9 Mayıs 2015 |
| Yayımlandığı Sayı | Yıl 2015 Cilt: 42 Sayı: 1 |