Capacidad predictiva del euroscore II en una cohorte de pacientes de cirugía cardiovascular en una institución de cuarto nivel de Bogotá

Abstract

The EuroSCORE II is one of the risk scales most used as predictor of risk mortality in the cardiovascular surgery services. It has been validated in different hospitals around the world showing an accurate capacity to discriminate. The aim of this study is assess the predictive value of the risk scale EuroSCORE II in the patients who underwent cardiovascular surgery in a forth level institution in Bogotá. Methodology: Observational, retrospective diagnostic test study of the cohort of patients in a forth level institution during the period between 2012 to 2014. The EuroSCORE calculation was performed for each patient and the comparison was made between the predicted mortality in this population versus the observed, globally and by risk group. Results: Of the total population which underwent a mayor cardiac intervention in a forth level institution in the cohort studied 58 cases of death occurred within thirty days after the intervention, which corresponds to 7.46%. The expected mortality calculated with EuroSCORE II was 9.26%, which indicated a good power of prediction for this population. On the other hand, the ROC curve evidenced with a value of 0.757 under the area of the curve, that the model El EuroSCORE II is a good predictive model with an adequate discrimination value. It was noted, that the variables preoperative critical state and left ventricular function have a higher statistical weight in our target population, with a significance of 0001, followed by acute myocardial infarction, sex and weight of the intervention with a significance of 0,01. Additionally, the Euroscore II has better predictive value when only one procedure or a revascularization procedure was performed, compared to when mixed procedures were performed. It is recommended to perform a multicenter study where patients with different demographic characteristics are included.