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Risk score estimated short-term mortality after CABG surgery
A risk score based on 30-day and in-hospital mortality appears to be a simple method to estimate short-term mortality for patients who undergo CABG surgery.
“Previous risk scores have been based on in-hospital mortality, but a substantial number of patients die within 30 days of the procedure. These deaths should also be accounted for, so we developed a risk score based on in-hospital and 30-day mortality,” researchers wrote in the study abstract.
The study tested the accuracy of the risk score on 10,148 patients undergoing CABG surgery in 2009. The logistic regression model, based on New York’s Cardiac Surgery Reporting System, was converted into a linear risk score to provide estimates of mortality rates for different values of the score.
According to data, the overall in-hospital mortality and 30-day mortality rate was 1.79%.
The risk score utilizes seven risk factors with scores ranging from 1 to 5. The highest possible total score is 23. Patients in the study with the highest risk scores were aged 81 years or older and had hemodynamic instability.
“The score accurately predicted mortality in 2009 as well as in 2008, and was strongly correlated with complications and length of stay,” the researchers wrote.
Due to the trend of shorter hospital stays, more patients are dying within a shorter time period (less than 30 days) after discharge, according to background information in the study. Strengths of the risk score tested in this study include: the use of population-based data, including all patients in a given region in the analyses, and the use of both 30-day and in-hospital mortality as the outcome measure. Of note, the risk score developed did not include patients who met the Cardiac Surgery Reporting System definition of shock due to concerns about the potential dangers of public reporting for that patient population.
Disclosure: The researchers report no relevant financial disclosures.