Age, Creatinine and Ejection Fraction Score in Brazil: Comparison with InsCor and the EuroSCORE

Arq Bras Cardiol. 2015 Nov;105(5):450-6. doi: 10.5935/abc.20150101. Epub 2015 Aug 25.
[Article in English, Portuguese]

Abstract

Background: Risk scores for cardiac surgery cannot continue to be neglected.

Objective: To assess the performance of "Age, Creatinine and Ejection Fraction Score" (ACEF Score) to predict mortality in patients submitted to elective coronary artery bypass graft and/or heart valve surgery, and to compare it to other scores.

Methods: A prospective cohort study was carried out with the database of a Brazilian tertiary care center. A total of 2,565 patients submitted to elective surgeries between May 2007 and July 2009 were assessed. For a more detailed analysis, the ACEF Score performance was compared to the InsCor's and EuroSCORE's performance through correlation, calibration and discrimination tests.

Results: Patients were stratified into mild, moderate and severe for all models. Calibration was inadequate for ACEF Score (p = 0.046) and adequate for InsCor (p = 0.460) and EuroSCORE (p = 0.750). As for discrimination, the area under the ROC curve was questionable for the ACEF Score (0.625) and adequate for InsCor (0.744) and EuroSCORE (0.763).

Conclusion: Although simple to use and practical, the ACEF Score, unlike InsCor and EuroSCORE, was not accurate for predicting mortality in patients submitted to elective coronary artery bypass graft and/or heart valve surgery in a Brazilian tertiary care center.

Publication types

  • Observational Study

MeSH terms

  • Age Factors
  • Aged
  • Brazil
  • Calibration
  • Coronary Artery Bypass / mortality*
  • Creatinine / blood*
  • Elective Surgical Procedures / mortality
  • Epidemiologic Methods
  • Female
  • Heart Valve Diseases / mortality
  • Heart Valve Diseases / surgery
  • Heart Valve Prosthesis Implantation / mortality*
  • Humans
  • Male
  • Middle Aged
  • Models, Theoretical
  • Reference Values
  • Risk Assessment / methods*
  • Severity of Illness Index
  • Stroke Volume / physiology*
  • Tertiary Care Centers / statistics & numerical data

Substances

  • Creatinine