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Systematic review and meta-analysis of mortality risk prediction models in adult cardiac surgery
| Content Provider | Oxford Academic |
|---|---|
| Author | Sinha, Shubhra Dimagli, Arnaldo Dixon, Lauren Gaudino, Mario Caputo, Massimo Vohra, Hunaid A Angelini, Gianni Benedetto, Umberto |
| Copyright Year | 2021 |
| Description | Journal Title History: Respective Vols. [No.14 to 35] under the publication of Journal: 'Interactive CardioVascular and Thoracic Surgery' [Interact Cardiovasc Thorac Surg ; 2012 to 2022]. Then known as accordingly form Vols. 36 to 38, 'Interdisciplinary CardioVascular and Thoracic Surgery [Interdiscip Cardiovasc Thorac Surg: Vols. 36 to 38; 2023 to 2024]. |
| Abstract | Objectives: The most used mortality risk prediction models in cardiac surgery are the European System for Cardiac Operative Risk Evaluation (ES) and Society of Thoracic Surgeons (STS) score. There is no agreement on which score should be considered more accurate nor which score should be utilized in each population subgroup. We sought to provide a thorough quantitative assessment of these 2 models. METHODSWe performed a systematic literature review and captured information on discrimination, as quantified by the area under the receiver operator curve (AUC), and calibration, as quantified by the ratio of observed-to-expected mortality (O:E). We performed random effects meta-analysis of the performance of the individual models as well as pairwise comparisons and subgroup analysis by procedure type, time and continent.RESULTSThe ES2 {AUC 0.783 [95% confidence interval (CI) 0.765–0.800]; O:E 1.102 (95% CI 0.943–1.289)} and STS [AUC 0.757 (95% CI 0.727–0.785); O:E 1.111 (95% CI 0.853–1.447)] showed good overall discrimination and calibration. There was no significant difference in the discrimination of the 2 models (difference in AUC −0.016; 95% CI −0.034 to −0.002; P = 0.09). However, the calibration of ES2 showed significant geographical variations (P < 0.001) and a trend towards miscalibration with time (P=0.057). This was not seen with STS.CONCLUSIONSES2 and STS are reliable predictors of short-term mortality following adult cardiac surgery in the populations from which they were derived. STS may have broader applications when comparing outcomes across continents as compared to ES2.REGISTRATIONProspero (https://www.crd.york.ac.uk/PROSPERO/) CRD42020220983. |
| Related Links | https://academic.oup.com/icvts/article-pdf/33/5/673/42781390/ivab151.pdf |
| Ending Page | 686 |
| Starting Page | 673 |
| File Format | |
| e-ISSN | 15699285 |
| DOI | 10.1093/icvts/ivab151 |
| Journal | Interactive CardioVascular and Thoracic Surgery |
| Issue Number | 5 |
| Volume Number | 33 |
| Language | English |
| Publisher | Oxford Academic |
| Publisher Date | 2021-10-29 |
| Access Restriction | Open |
| Subject Keyword | Cardiothoracic Surgery Medicine and Health Surgery Cardiac Surgery Procedures Heart Thoracic Surgery Specialty Risk Prediction Rule Mortality Cardiac Surgery Prediction European System for Cardiac Operative Risk Evaluation Society of Thoracic Surgeons |
| Content Type | Text |
| Resource Type | Article |
| Subject | Cardiology and Cardiovascular Medicine Pulmonary and Respiratory Medicine Surgery |
