Variable | Survivors (N = 829) | Non survivors (N = 80) |
P value |
---|---|---|---|
Preoperative factors | |||
Age, years | 66.3 ± 11.2 | 68.9 ± 11.3 |
0.05
|
Sex, M/F male gender | 574 (69.2) | 48 (60) | 0.09 |
Peso, kg | 72.7 ± 15 | 71.9 ± 11.4 | 0.69 |
Talla, cm | 163.3 ± 9 | 162.3 ± 8.9 | 0.34 |
Hypertension | 449 (54.2) | 50 (62.5) | 0.15 |
Atrial fibrillation | 167 (20.1) | 23 (28.8) | 0.07 |
Diabetes mellitus | 198 (23.9) | 20 (25) | 0.82 |
Obesity | 132 (15.9) | 12 (15) | 0.82 |
Smoking | 114 (13.8) | 6 (7.5) | 0.11 |
Drinking alcohol | 50 (6) | 2 (2.5) | 0.19 |
Hepatic disease | 23 (2.8) | 3 (3.8) | 0.61 |
Respiratory disease | 93 (11.2) | 15(18.8) |
0.04
|
Chronic renal failure | 50 (6) | 11 (13.8) |
0.008
|
Immunosuppression | 23 (2.8) | 4 (5.0) | 0.26 |
Previous cardiac surgery | 79 (9.5) | 11 (13.8) | 0.61 |
Emergent surgery | 70 (8.4) | 23 (28.8) |
0.0001
|
Perioperative factors | |||
Left ventricle ejection fraction | 56.8 ± 11.5 | 49.6 ± 13.6 |
0.0001
|
Valve | 455 (54.9) | 47 (58.8) | 0.5 |
CABG | 399 (48.1) | 39 (48.8) | 0.91 |
Valve + CABG | 109 (13.1) | 20 (25.0) |
0.004
|
Total CPB time. min | 105.3 ± 44.29 | 156.1 ± 77.7 |
0.0001
|
Aortic cross-clamp time, min | 77.3 ± 37.04 | 106.9 ± 56.7 |
0.0001
|
Postoperative value | |||
Duration of mechanical ventilation, days | 25.23 ± 62.59 | 19.75 ± 31.43 | 0.81 |
Reintubation | 25 (3) | 16 (20) |
0.0001
|
Politrasfusion | 254 (30.6) | 25 (31.3) | 0.640 |
Acute renal failure | 67 (8.1) | 36 (45.0) |
0.0001
|
Reintervención | 21 (2.5) | 13 (16.3) |
0.0001
|
Intra-aortic balloon pump | 32 (3.9) | 27 (33.8) |
0.0001
|
Pneumonia | 35 (4.2) | 15 (18.8) |
0.0001
|
Surgical site infections | 25 (3) | 1 (1.3) | 0.36 |
Preoperative hospitalization, days | 18.2 ± 15.5 | 10.6 ± 11.3 |
0.0001
|
Mean ICU stay, days | 4.7 ± 12.1 | 14.3 ± 20.9 |
0.0001
|
Duration of hospitalization after surgery, days | 22.8 ± 20.9 | 24.9 ± 23.7 | 0.43 |
Risk score | |||
Additive EuroSCORE, points | 4.5 ± 2.8 | 7.4 ± 4.5 |
0.0001
|
Logistic EuroSCORE, points | 5.4 ± 6.2 | 16.7 ± 18.5 |
0.0001
|
ACEF score, points | 1.2 ± 0.4 | 1.7 ± 0.6 |
0.0001
|
SOFA score, points | 5.5 ± 1.7 | 7.7 ± 1.7 |
0.0001
|
SAP II score, points | 28.9 ± 8.7 | 43.0 ± 11.6 |
0.0001
|
APACHE II score, points | 13.3 ± 3.8 | 18.3 ± 5.6 |
0.0001
|
Variable | Survivors (n = 829) | Non-survivors (n = 80) |
p value |
---|---|---|---|
pH | 7.37 ± 0.06 | 7.31 ± 0.9 |
0.0001
|
HCO3
− mEq/l | 24.4 ± 3.15 | 21.04 ± 3.9 |
0.0001
|
PCO2, mmHg | 41.0 ± 6.3 | 41.3 ± 6.2 | 0.69 |
PaO2/FiO2, range | 245.6 ± 72.8 | 226.2 ± 77.1 |
0.024
|
Core temperature, °C | 36.6 ± 0.8 | 36.7 ± 1.5 | 0.22 |
Leukocyte count, cells/mm3
| 10535.1 ± 6396.8 | 13454.8 ± 5727.4 |
0.0001
|
C-reactive protein, mg/L | 14.3 ± 35.1 | 29.5 ± 53.1 |
0.014
|
Procalcitonin, ng/mL | 0.8 ± 4.9 | 3.1 ± 5. |
0.0001
|
Lactates, mmol/L | 29.4 ± 14.9 | 63.6 ± 43.7 |
0.0001
|
ScvO2, % | 73.4 ± 8.6 | 65.6 ± 12.3 |
0.0001
|
Heart rate, beats/min | 92.3 ± 18.5 | 109.7 ± 17.2 |
0.0001
|
Mean arterial pressure, mmHg | 72.5 ± 13.7 | 53.6 ± 10.5 |
0.0001
|
Glucose, mg/dl | 181 ± 57.2 | 193.7 ± 70.5 | 0.13 |
Creatinine, mg/dl | 1 ± 0.5 | 1.5 ± 1.3 |
0.001
|
Hematocrit, % | 29.1 ± 4.4 | 28 ± 4.5 |
0.04
|
Na, mmol/L | 140.1 ± 7.6 | 142 ± 4.8 |
0.028
|
K, mmol/L | 3.9 ± 0.6 | 4 ± 0.7 | 0.47 |
TnT, μg/l | 0.8 ± 1.4 | 3.8 ± 6.1 |
0.0001
|
CK-MB, ng/mL | 336.4 ± 283.2 | 161.6 ± 186.4 |
0.0001
|
INR, range | 1.5 ± 0.2 | 2 ± 0.8 |
0.0001
|
aPTTr, range | 1.2 ± 0.3 | 1.8 ± 1.2 |
0.0001
|
Platelet count, cells/mm3
| 119490.8 ± 47226.4 | 119898.7 ± 65476.3 | 0.95 |
B | SE |
p value | OR | 95 % CI | |
---|---|---|---|---|---|
Constant | −11.561 | 1.155 | 0.0001 | 0.0001 | |
1000/MAP (mmHg) | 0.308 | 0.046 | 0.0001 | 1.360 | 1.242–1.489 |
1000/Bicarbonate (mEq/L) | 0.034 | 0.013 | 0.011 | 1.035 | 1.008–1.062 |
Lactate (mg/dL) | 0.022 | 0.007 | 0.001 | 1.023 | 1.009–1.036 |
INR | 1.025 | 0.397 | 0.0101 | 2.788 | 1.282–6.064 |
Lactate (mmol/L) | Score | INR | Score |
<16.00 | 3 | <1.31 | 12 |
16.00 to 24.90 | 4 | 1.31 to 1.52 | 14 |
25.00 to 34.90 | 6 | 1.53 to 1.94 | 16 |
35.00 to 52.90 | 9 | 1.95 to 2.65 | 20 |
53.00 to 79.00 | 14 | >2.65 | 30 |
>79.00 | 21 | ||
MAP (mm Hg) | Score | Bicarbonate (mEq/L) | Score |
>75 | 35 | >27.4 | 14 |
69 to 75 | 41 | 25.7 to 27.4 | 15 |
61 to 68 | 46 | 24.1 to 25.6 | 16 |
60 | 50 | 22.8 to 24.0 | 17 |
45 to 59 | 58 | 20.4 to 22.7 | 18 |
<45 | 75 | 14.6 to 20.3 | 22 |
<14.6 | 35 |
B | SE |
p value | OR | 95 % CI | ||
---|---|---|---|---|---|---|
POCAS | 0.113 | 0.011 | 0.0001 | 1.119 | 1.096 | 1.143 |
Constant | −12.671 | 1.051 | 0.0001 | 0.000 |
Risk score | Observed no. | Predicted no. | % probability (95 % CI) | 90-Day In-Hospital Mortality (%) | Operative risk categories | % probability (95 % CI) |
---|---|---|---|---|---|---|
<75 | 1 | 1 | 0.92 (0.89–0.95) | 0.4 | Low | 2.33 (2.19–2.46) |
75–81 | 3 | 3 | 2.10 (2.03–2.16) | 1.5 | ||
82–90 | 11 | 11 | 4.82 (4.62–5.02) | 6.1 | ||
91–100 | 12 | 12 | 12.99 (12.34–13.65) | 11.1 | Medium | 16.32 (15.25–17.38) |
101–105 | 11 | 10 | 25.53 (24.40–26.66) | 28.2 | ||
106–128 | 29 | 28 | 56.22 (51.86–60.58) | 55.8 | High | 56.22 (51.86–60.58) |
>128 | 13 | 13 | 94.98 (92.75–97.21) | 100.0 | Very high | 94.98 (92.75–97.21) |
Criterion for assigning a mortality | AUC [95 % IC] | Ind.Youden Máx | Cutoff value | Sensitivity | Specifity | NPV | PPV |
Χ
2 test AUCs (other scale*POCAS) |
---|---|---|---|---|---|---|---|---|
POCAS | 0.899 [0.864–0.934]* | 0.63 | 85.5 | 0.91 | 0.72 | 98.7 | 24.9 | -- |
APACHE II | 0.768 [0.709–0.828]* | 0.42 | 17.5 | 0.54 | 0.88 | 95.2 | 30.7 | 20.42* |
SOFA | 0.825 [0.782–0.867]* | 0.52 | 5.5 | 0.92 | 0.59 | 98.7 | 18.8 | 10.16** |
SAPS II | 0.847 [0.800–0.893]* | 0.56 | 32.5 | 0.85 | 0.71 | 98.2 | 20.1 | 24.10* |
ACEF | 0.699 [0.639–0.758]* | 0.31 | 1.49 | 0.50 | 0.81 | 93.5 | 22.3 | 652.30* |
Logistic EuroSCORE | 0.754 [0.693–0.814]* | 0.40 | 4.11 | 0.81 | 0.58 | 96.7 | 17.3 | 398.28* |
Additive EuroSCORE | 0.714 [0.647–0.780]* | 0.38 | 5.50 | 0.71 | 0.67 | 95.4 | 19.2 | 30.39* |