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Master Thesis

Évolution du profil de risque des patients en chirurgie cardiaque‎ : performance des scores de gravité

Abstract : Introduction: Over 13.5 years, a change in severity of patients undergoing cardiac surgery has been observed but is not associated with an increased mortality. Thus the aim of this study was to evaluate these changes using severity scores and determine changes in the independent predictors of in-hospital mortality.Methods: Data of 6768 patients undergoing cardiac surgery in our hospital were prospectively collected between January 1998 and June 2011. These 13.5 years were divided in 3 periods of 4.5 years. Parsonnet score, Tu (Ontario) score and additive and logistic EuroSCORE were calculated as described in the original studies. The main end point was hospital mortality. Accuracy of risk scores was assessed by ROC curves analysis. Results: Mean values of the different scores increased with time, but not mortality. The additive and logistic EuroSCORE AUC was 0.82 and did not significantly change during the 3 periods and was significantly higher than the AUC of Tu and Parsonnet scores (0.77, p=0.0001). Mortality among higher risk patients with LV dysfunction decreased from 15 to 9% (p=0.05). Mortality among higher risk patients older than 70 years decreased from 12 to 8% (p=0.08). Conclusion: Despite an increase in estimated operative risk, postoperative mortality did not significantly increase during the study period. This may be due to improved perioperative care especially for oldest patients or patient with LV dysfunction.
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https://dumas.ccsd.cnrs.fr/dumas-00693338
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Submitted on : Wednesday, May 2, 2012 - 2:42:31 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:17 AM
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  • HAL Id : dumas-00693338, version 1

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Sophie Pichegru. Évolution du profil de risque des patients en chirurgie cardiaque‎ : performance des scores de gravité. Médecine humaine et pathologie. 2012. ⟨dumas-00693338⟩

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