HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Jari Laurikka Matti Tarkka Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kurki, T. S. Articles by Tarkka, M. Search for Related Content PubMed PubMed Citation Articles by Kurki, T. S. Articles by Tarkka, M. Related Collections Coronary disease

Eur J Cardiothorac Surg 2002;21:406-410
© 2002 Elsevier Science NL

Performance of three preoperative risk indices; CABDEAL, EuroSCORE and Cleveland models in a prospective coronary bypass database

^a Department of Anaesthesia and Intensive Care Medicine, HUCH, Meilahti Hospital, FIN-00029 HUS, Helsinki, Finland
^b Department of Cardiothoracic Surgery, Tampere University Hospital, Tampere, Finland
^c National Public Health Institute, Helsinki, Finland

Received 7 October 2001; received in revised form 18 December 2001; accepted 21 December 2001.

* Corresponding author. Lukupolku 19, 00680 Helsinki, Finland. Tel.: +358-9-47161781
e-mail: tuula.kurki{at}hus.fi

Objectives: The aim of the present study was to evaluate the performance of three different preoperative risk models in the prediction of postoperative morbidity and mortality in coronary artery bypass (CAB) surgery. Methods: Data on 1132 consecutive CAB patients were prospectively collected, including preoperative risk factors and postoperative morbidity and in-hospital mortality. The preoperative risk models CABDEAL, EuroSCORE and Cleveland model were used to predict morbidity and mortality. A C statistic (receiver operating characteristic (ROC) curve) was used to test the discrimination of these models. Results: The area under the ROC curve for morbidity was 0.772 for the CABDEAL, 0.694 for the EuroSCORE and 0.686 for the Cleveland model. Major morbidity due to postoperative complications occurred in 268 patients (23.6%). The mortality rate was 3.4% (n=38 patients). The ROC curve areas for prediction of mortality were 0.711 for the CABDEAL, 0.826 for the EuroSCORE and 0.858 for the Cleveland model. Conclusions: The CABDEAL model was initially developed for the prediction of major morbidity. Thus, it is not surprising that this model evinced the highest predictive value for increased morbidity in this database. Both the Cleveland and the EuroSCORE models were better predictive of mortality. These results have implications for the selection of risk indices for different purposes. The simple additive CABDEAL model can be used as a hand-held model for preoperative estimation of patients' risk of postoperative morbidity, while the EuroSCORE and Cleveland models are to be preferred for the prediction of mortality in a large patient sample.

Key Words: Preoperative risk factors • Coronary artery bypass surgery • CABDEAL • Cleveland model • EuroSCORE • Bayesian approach

This article has been cited by other articles:

				M. L. Bell, G. K. Grunwald, J. H. Baltz, G. O. McDonald, M. R. Bell, F. L. Grover, and A. L. W. Shroyer Does preoperative hemoglobin independently predict short-term outcomes after coronary artery bypass graft surgery? Ann. Thorac. Surg., November 1, 2008; 86(5): 1415 - 1423. [Abstract] [Full Text] [PDF]

				J. Granton and D. Cheng Risk Stratification Models for Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2008; 12(3): 167 - 174. [Abstract] [PDF]

				A. A. Fox, S. K. Shernan, C. D. Collard, K.-Y. Liu, S. F. Aranki, S. M. DeSantis, P. Jarolim, and S. C. Body Preoperative B-type natriuretic peptide is as independent predictor of ventricular dysfunction and mortality after primary coronary artery bypass grafting. J. Thorac. Cardiovasc. Surg., August 1, 2008; 136(2): 452 - 461. [Abstract] [Full Text] [PDF]

				E. A. Grossi, C. F. Schwartz, P.-J. Yu, U. P. Jorde, G. A. Crooke, J. B. Grau, G. H. Ribakove, F. G. Baumann, P. Ursumanno, A. T. Culliford, et al. High-Risk Aortic Valve Replacement: Are the Outcomes as Bad as Predicted? Ann. Thorac. Surg., January 1, 2008; 85(1): 102 - 107. [Abstract] [Full Text] [PDF]

				O. Staudinger, H. Ostermann, G. Laufer, R. Schistek, B. Staudinger, and B. Tilg Evaluation of cardiac scoring models for an Austrian cardiac register Interactive CardioVascular and Thoracic Surgery, August 1, 2007; 6(4): 470 - 473. [Abstract] [Full Text] [PDF]

				F. Onorati, M. De Feo, P. Mastroroberto, L. Cristodoro, F. Pezzo, A. Renzulli, and M. Cotrufo Determinants and Prognosis of Myocardial Damage After Coronary Artery Bypass Grafting Ann. Thorac. Surg., March 1, 2005; 79(3): 837 - 845. [Abstract] [Full Text] [PDF]

				I. K. Toumpoulis, C. E. Anagnostopoulos, D. G. Swistel, and J. J. DeRose Jr Does EuroSCORE predict length of stay and specific postoperative complications after cardiac surgery? Eur. J. Cardiothorac. Surg., January 1, 2005; 27(1): 128 - 133. [Abstract] [Full Text] [PDF]

				C.-C. Chen, C.-C. Wang, S.-R. Hsieh, H.-W. Tsai, H.-J. Wei, and Y. Chang Application of European system for cardiac operative risk evaluation (EuroSCORE) in coronary artery bypass surgery for Taiwanese Interactive CardioVascular and Thoracic Surgery, December 1, 2004; 3(4): 562 - 565. [Abstract] [Full Text] [PDF]

				O. Jarvinen, J. Julkunen, T. Saarinen, J. Laurikka, H. Huhtala, and M. R. Tarkka Perioperative myocardial infarction has negative impact on health-related quality of life following coronary artery bypass graft surgery Eur. J. Cardiothorac. Surg., September 1, 2004; 26(3): 621 - 627. [Abstract] [Full Text] [PDF]

				G. Vanagas Receiver operating characteristic curves and comparison of cardiac surgery risk stratification systems Interactive CardioVascular and Thoracic Surgery, June 1, 2004; 3(2): 319 - 322. [Abstract] [Full Text] [PDF]

				I. K. Toumpoulis, C. E. Anagnostopoulos, J. J. DeRose, and D. G. Swistel European system for cardiac operative risk evaluation predicts long-term survival in patients with coronary artery bypass grafting Eur. J. Cardiothorac. Surg., January 1, 2004; 25(1): 51 - 58. [Abstract] [Full Text] [PDF]

				R. V.H.P. Huijskes, P. M.J. Rosseel, and J. G.P. Tijssen Outcome prediction in coronary artery bypass grafting and valve surgery in the Netherlands: development of the Amphiascore and its comparison with the Euroscore Eur. J. Cardiothorac. Surg., November 1, 2003; 24(5): 741 - 749. [Abstract] [Full Text] [PDF]

				O. Jarvinen, T. Saarinen, J. Julkunen, H. Huhtala, and M. R. Tarkka Changes in health-related quality of life and functional capacity following coronary artery bypass graft surgery Eur. J. Cardiothorac. Surg., November 1, 2003; 24(5): 750 - 756. [Abstract] [Full Text] [PDF]

				P. Michel, F. Roques, S. A.M. Nashef, and The EuroSCORE Project Group Logistic or additive EuroSCORE for high-risk patients? Eur. J. Cardiothorac. Surg., May 1, 2003; 23(5): 684 - 687. [Abstract] [Full Text] [PDF]

				G. L. Grunkemeier, K.J. Zerr, and R. Jin Reply Ann. Thorac. Surg., November 1, 2002; 74(5): 1749 - 1749. [Full Text] [PDF]