Background
Methods
Data
Severity of illness scores
Statistical analyses
Prediction models
Hospital mortality
ICU mortality
Performance assessment of the models
Ethics
Results
Demographics, Procedures, models & outcome | All patients | Q1 [SOFA 0–4] | Q2 [SOFA 5–6] | Q3 [SOFA 7–8] | Q4 [SOFA 9–22] |
---|---|---|---|---|---|
N | 36,632 | 13,039 | 5486 | 11,848 | 6259 |
Age (mean; sd) | 66.6 (11.4) | 65.6 (11.9) | 65.9 (11.1) | 67.3 (10.7) | 68.2 (11.3) |
Male (%) | 70.7 | 70.3 | 71 | 71 | 71 |
BMI (mean; sd) | 27.2 (4.5) | 27.2 (4.6) | 27.4 (4.5) | 27.1 (4.3) | 26.8 (4.5) |
Renal Insufficiency (%) | 3.2 | 1.8 | 2 | 2.5 | 8.7 |
Emergency Surgery (%) | 5.3 | 4.3 | 4.9 | 4.8 | 8.8 |
CABG (%) | 51.6 | 56.1 | 58.3 | 51.1 | 37.3 |
Valve surgery Only (%) | 24.9 | 24.5 | 22.7 | 25.3 | 26.9 |
Valve surgery and CABG (%) | 11.9 | 7.6 | 9.2 | 14.1 | 18.9 |
Aorta surgery Only (%) | 4.4 | 4.9 | 3.9 | 3.7 | 5.2 |
Myocardial surgery only (%) | 1.4 | 1.8 | 0.9 | 1.2 | 1.5 |
Combination surgery (%) | 5.8 | 5.2 | 5 | 4.6 | 10.3 |
Apache IV predicted mortality (%) | 3 | 1.6 | 2.0 | 2.6 | 7.9 |
Apache III scorea (mean; sd) | 47 (16.9) | 41 (13.4) | 44.8 (13.6) | 47.6 (14.6) | 60.4 (21.8) |
Apache II predicted mortality (%) | 7.6 | 5.5 | 6.6 | 7.6 | 13 |
Apache II score (mean; sd) | 14 (4.6) | 12.2 (3.7) | 13.5 (3.8) | 14.5 (4.0) | 17.3 (5.8) |
SAPS II predicted mortality (%)) | 12.8 | 8.5 | 10.8 | 12.9 | 23.1 |
SAPS II score (mean; sd) | 29.4 (9.3) | 25.7 (7.0) | 28.2 (7.5) | 30.1 (7.9) | 36.7 (12.5) |
MPM24-II predicted mortality (%) | 13.5 (8.9) | 11.4 (7.5) | 11.4 (7.1) | 14.2 (7.4) | 18.7 (12.5) |
ICU mortality (%) | 1.3 | 0.1 | 0.2 | 1 | 5.4 |
Hospital mortality (%) | 2.2 | 0.6 | 0.8 | 1.8 | 7.6 |
Performance assessment of the models
Models | AUC (CI 95%)* | Brier score (CI 95%) | Ĉ-statistic (CI)* | Ĉ-statistic p-value |
---|---|---|---|---|
APACHE IV – model | 0.851 (0.851–0.851) | 0.019 (0.019–0.019) | 27.0 (24.1–36.4) | < 0.0001 |
APACHE II – model | 0.830 (0.830–0.830) | 0.020 (0.19–0.20) | 16.3 (12.6–24.8) | 0.0308 |
SOFA - model | 0.809 (0.808–0.810) | 0.020 (0.019–0.20) | 43.7 (31.5–61.1) | < 0.0001 |
SAPS-II - model | 0.850 (0.850–0.850) | 0.019 (0.019–0.019) | 19.4 (11.0–33.5) | 0.009 |
MPM24-II - model | 0.801 (0.801–0.801) | 0.020 (0.20–0.020) | 30.3 (28.7–37.6) | < 0.0001 |
Models | AUC (CI 95%) * | Brier score (CI 95%) | Ĉ-statistic (CI)* | Ĉ-statistic p-value |
---|---|---|---|---|
APACHE IV – model | 0.906 (0.904–0.906) | 0.011 (0.011–0.011) | 38.5 (30.2–54.8) | < 0.001 |
APACHE II – model | 0.892 (0.891–0.893) | 0.011 (0.011–0.011) | 27.1 (14.1–35.4) | 0.001 |
SOFA - model | 0.865 (0.864–0.866) | 0.012 (0.012–0.012) | 16.4 (12.9–25.1) | 0.030 |
SAPS-II - model | 0.919 (0.917–0.919) | 0.011 (0.011–0.012) | 9.7 (5.7–21.3) | 0.215 |
MPM24-II - model | 0.862 (0.860–0.863) | 0.012 (0.012–0.012) | 7.2 (2.8–15.3) | 0.462 |
SOFA components | AUC (CI 95%)* | Brier score (CI 95%) | Ĉ-statistic (CI)* | Ĉ-statistic p-value |
---|---|---|---|---|
SOFA – Total | 0.809 (0.808–0.810) | 0.020 (0.019–0.20) | 43.7 (31.5–61.1) | < 0.001 |
SOFA – Respiratory | 0.654 (0.651–0.656) | 0.022 (0.022–0.022) | 10.7 (5.1–22.0) | 0.170 |
SOFA – Coagulation | 0.707 (0.702–0.709) | 0.021 (0.021–0.021) | 8.8 (4.0–21.1) | 0.283 |
SOFA – Hepatogenic | 0.706 (0.704–0.707) | 0.021 (0.021–0.021) | 9.5 (4.8–19.6) | 0.267 |
SOFA – Circulation | 0.718 (0.715–0.719) | 0.021 (0.021–0.021) | 16.3 (7.16–33.7) | 0.021 |
SOFA – Renal | 0.741 (0.736–0.745) | 0.021 (0.021–0.021) | 31.0 (19.0–44.9) | < 0.001 |
SOFA – Neurology | 0.691 (0.689–0.692) | 0.021 (0.021–0.021) | 10.1 (4.3–19.3) | 0.245 |
SOFA components | AUC (CI 95%)* | Brier score (CI 95%) | Ĉ-statistic (CI)* | Ĉ-statistic p-value |
---|---|---|---|---|
SOFA – Total | 0.865 (0.864–0.866) | 0.012 (0.012–0.012) | 16.4 (12.9–25.1) | 0.030 |
SOFA – Respiratory | 0.634 (0.630–0.637) | 0.013 (0.013–0.013) | 9.7 (3.1–19.9) | 0.253 |
SOFA – Coagulation | 0.728 (0.726–0.730) | 0.013 (0.013–0.013) | 37.6 (13.1–61.4) | < 0.001 |
SOFA – Hepatogenic | 0.721 (0.719–0.722) | 0.013 (0.013–0.013) | 14.2 (8.1–23.7) | 0.066 |
SOFA – Circulation | 0.733 (0.730–0.734) | 0.013 (0.013–0.013) | 81.3 (33.4–134.8) | < 0.001 |
SOFA – Renal | 0.771 (0.763–0.777) | 0.013 (0.013–0.013) | 40.0 (27.5–54.1) | < 0.011 |
SOFA – Neurology | 0.668 (0.663–0.671) | 0.013 (0.013–0.013) | 18.7 (8.7–32.9) | 0.014 |