Evaluation of the Society of Thoracic Surgeons score system
               for isolated coronary bypass graft surgery in a Brazilian population

Ikeoka, Dimas Tadahiro; Fernandes, Viviane Aparecida; Gebara, Otavio; Garcia, Jose Carlos Teixeira; Silva, Pedro Gabriel Melo de Barros e; Rodrigues, Marcelo Jamus; Furlan, Valter; Baruzzi, Antonio Claudio do Amaral

doi:10.5935/1678-9741.20140011

Dimas Tadahiro Ikeoka Correspondence address: Dimas Tadahiro Ikeoka, Hospital TotalCor, Alameda Santos, 764 - Cerqueira César, São Paulo, SP, Brazil - Zip code: 01418-100, E-mail: dimas.ikeoka@hotmail.com

Viviane Aparecida Fernandes

Otavio Gebara

Jose Carlos Teixeira Garcia

Pedro Gabriel Melo de Barros e Silva

Marcelo Jamus Rodrigues

Valter Furlan

Antonio Claudio do Amaral Baruzzi

Correspondence address: Dimas Tadahiro Ikeoka, Hospital TotalCor, Alameda Santos, 764 - Cerqueira César, São Paulo, SP, Brazil - Zip code: 01418-100, E-mail: dimas.ikeoka@hotmail.com

Figures (3)
Tables (5)

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Fig. 1
Observed and expected (mean) mortality rates divided by quintiles of expected mortality, as calculated by the STS scoring system. Goodness of fit Chi-square test has shown that the pattern of distribution of expected and observed mortality did not significantly differ in the study population (X2=1.06, P=0.90)

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Fig. 2
Observed (black columns) and expected (mean, white columns) general morbidity rates distributed according to the quintiles of expected mortality, as calculated by the STS scoring system. Goodness of fit Chi-square test has shown that the pattern of distribution of expected and observed morbidity rates did not significantly differ in the study population (X2=6.77, P=0.15)

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Fig. 3
ROC-curves showing relation between sensitivity and 1-specificity for STS scoring system for seven postoperative outcomes measured: A) mortality; B) morbidity; C) renal failure; D) prolonged length of hospital stay; E) reoperation; F) prolonged mechanical ventilation and G) short length of hospital stay

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Abbreviations, acronyms & symbols AUC Area under the curve CABG Coronary artery bypass graft CAD Coronary artery disease EuroSCORE European System for Cardiac Operative Risk Evaluation LOS Length of stay PLOS Prolonged postoperative length of stay ROC Receiver operating characteristic STS Society of Thoracic Surgeons

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Table 1
Baseline demographic and clinical characteristics of the studied population submitted to CABG procedures (659 patients) at TotalCor Hospital, between January, 2010 and December, 2011.

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Table 2
Hosmer-Lemeshow contingence table for goodness of fit as determined for mortality in isolated CABG patients. Calculated Chi-square = 6.89 P=0.55.

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Table 3
Hosmer-Lemeshow contingence table for goodness of fit as determined for general morbidity in isolated CABG patients. Calculated Chi-square = 6.69 P=0.57.

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Authors' roles & responsibilities DTI Idealization of study, methodology defining, data analysis, writing of the manuscript, final approval VAF Data collection, discussion of methodology, discussion and presentation of results, final approval OG Discussion of methodology and results, discussion and assistance in drafting the manuscript, final approval JCTG Data collection, methodology and discussion of results, discussion of the manuscript, final approval PGMBS Review of manuscript, final approval MJR Discussion of methodology and results, discussion and assistance in the composition of the manuscript, final approval VF Discussion of methodology and results, aid in the composition of the manuscript, final approval ACAB Idealization of work, methodology and discussion of results, discussion of the manuscript, final approval

Variable	Frequency
Patient age (years)	61.2
Female	24%
Race (percent Caucasian)	95%
Obese or morbid obesity	26%
Diabetes	42%
Last creatinine level preoperatively (median; 25 - 75 percentile - mg/dL)	1.0; 0.9 - 1.2
Previous cardiac surgery	2.4%
Cerebrovascular disease	1.8%
Myocardial infarction (< 21 days prior to surgery)	45%
ST elevation or NST elevation on admission	43.3%
Arrhythmia	3.0%
Coronary vessels (three)	91.5%
Left main disease > or = 50%	14.6%
Ejection fraction < 40%	4.2%
Aortic stenosis	10%
Mitral insufficiency (mild)	30%
Status of the procedure (urgent or emergent)	40%

Deciles of risk	Survival		Death		Total
	Observed	Expected	Observed	Expected
1^st	40	40.4	1	0.65	41
2^nd	42	41.3	0	0.71	42
3^rd	56	55.0	0	0.97	56
4^th	46	45.2	0	0.83	46
5^th	46	46.1	1	0.88	47
6^th	48	47.1	0	0.93	48
7^th	47	48.0	2	1.02	49
8^th	46	45.9	1	1.10	47
9^th	45	46.5	3	1.32	48
10^th	61	61.4	6	5.62	67

Deciles of risk	Event free		Any event		Total
	Observed	Expected	Observed	Expected
1^st	47	46.9	2	2.11	49
2^nd	48	46.8	2	3.23	50
3^rd	44	45.3	5	3.68	49
4^th	47	43.7	1	4.30	48
5^th	44	45.8	7	5.23	51
6^th	44	42.2	4	5.79	48
^7th	40	41.9	9	7.10	49
8^th	40	41.2	10	8.84	50
9^th	38	36.1	11	12.94	49
10^th	23	25.2	25	22.78	48

[1] Correspondence address: Dimas Tadahiro Ikeoka, Hospital TotalCor, Alameda Santos, 764 - Cerqueira César, São Paulo, SP, Brazil - Zip code: 01418-100, E-mail: dimas.ikeoka@hotmail.com

Brasil

Brasil

Evaluation of the Society of Thoracic Surgeons score system for isolated coronary bypass graft surgery in a Brazilian population

Avaliação dos escores da Society of Thoracic Surgeons para cirurgia de revascularização miocárdica isolada em uma população brasileira

Objective:

Methods:

Results:

Conclusion: