gms | German Medical Science

129. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

24.04. - 27.04.2012, Berlin

Risk stratification with the EuroSCORE for prolonged duration of intensive unit care stay following cardiac surgery

Meeting Abstract

  • Sems-Malte Tugtekin - Herzzentrum Dresden, Herzchirurgie, Dresden
  • Dominik Joskowiak - Herzzentrum Dresden, Herzchirurgie, Dresden
  • Utz Kappert - Herzzentrum Dresden, Herzchirurgie, Dresden
  • Kostas Alexiou - Herzzentrum Dresden, Herzchirurgie, Dresden
  • Christian Georgi - Herzzentrum Dresden, Herzchirurgie, Dresden
  • Manuel Wilbring - Herzzentrum Dresden, Herzchirurgie, Dresden
  • Klaus Matschke - Herzzentrum Dresden, Herzchirurgie, Dresden

Deutsche Gesellschaft für Chirurgie. 129. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 24.-27.04.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12dgch176

DOI: 10.3205/12dgch176, URN: urn:nbn:de:0183-12dgch1762

Published: April 23, 2012

© 2012 Tugtekin et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Introduction: Improvement of surgical techniques and advancement of intensive care therapy led to increased number of patients (pts) with a higher risk profile scheduled to cardiac surgery. An increased morbidity of these pts is probably related to longer postoperative stay on ICU (Intensive Care Unit) resulting in higher costs and poor outcome. Risk stratification systems have therefore become essential tools to predict the risk for prolonged ICU stay. The purpose of this study was to investigate the predictive value of the EuroSCORE for prolonged ICU stay after cardiac surgery.

Materials and methods: 7640 patients underwent CABG and/or valve or aortic surgery in our institution between January 2007 and December 2010. Clinical data, including the EuroSCORE values as well as the postoperative course of all pts were recorded and studied retrospectively. The primary endpoint was the length of ICU stay in days. Three subsequent ICU stays were defined: until 4 days (n=6574; short term), 4-7 days (n=466; intermediate term) and 7 days (n=600; prolong term). The predictive performance of EuroSCORE was analysed by the discriminatory power of a receiver operating characteristic (ROC) curve.

Results: The mean ICU stay was 2.2 ± 3.4 days. Pts had a median additive EuroSCORE of 6 (range, 0-23) and a median logistic EuroSCORE of 5.7% (range, 0.9-95.9). In the logistic EuroSCORE model, a predictive value of 0.73 for an ICU stay until 4 days, 0.67 for > 4-7 days and 0.75 for > 7 days was found. The additive EuroSCORE model revealed an area under the ROC curve of 0.73, 0.67 and 0.75 for the defined ICU stays, respectively.

Conclusion: In a large study population, length of stay on the ICU correlated positively with both EuroSCORE models. Risk stratification with the EuroSCORE was more discriminatory for a short and prolonged ICU stay (> 7 days). Therefore, EuroSCORE seems to be a useful predicting tool and provides physicians with a good estimate of patients risk according their ICU stay following cardiac surgery.