Assessment of PIM-2 performance among surgical patients with heart disease and correlation of results with RACHS-1.

Autor: Rezende RQ; Hospital da Criança Santo Antônio, Irmandade Santa Casa de Misericórdia de Porto Alegre - Porto Alegre (RS), Brasil., Ricachinevsky CP; Hospital da Criança Santo Antônio, Irmandade Santa Casa de Misericórdia de Porto Alegre - Porto Alegre (RS), Brasil., Botta A; Hospital da Criança Santo Antônio, Irmandade Santa Casa de Misericórdia de Porto Alegre - Porto Alegre (RS), Brasil., Angeli VR; Hospital da Criança Santo Antônio, Irmandade Santa Casa de Misericórdia de Porto Alegre - Porto Alegre (RS), Brasil., Nogueira AJDS; Hospital da Criança Santo Antônio, Irmandade Santa Casa de Misericórdia de Porto Alegre - Porto Alegre (RS), Brasil.
Jazyk: Portuguese; English
Zdroj: Revista Brasileira de terapia intensiva [Rev Bras Ter Intensiva] 2017 Oct-Dec; Vol. 29 (4), pp. 453-459.
DOI: 10.5935/0103-507X.20170069
Abstrakt: Objective: To assess the performance of the Pediatric Index of Mortality (PIM) 2 and the Risk Adjustment for Congenital Heart Surgery (RACHS) in the postoperative period of congenital heart disease patients.
Methods: Retrospective cross-sectional study. Data were collected from patient records to generate the scores and predictions using recommended techniques, demographic data and outcomes. The Mann-Whitney test, Hosmer-Lemeshow test, standardized mortality rate, area under the receiver operating characteristic (ROC) curve, chi square test, Poisson regression with robust variance and Spearman's test were used for statistical analysis.
Results: A total of 263 patients were evaluated, and 72 died (27.4%). These patients presented significantly higher PIM-2 values than survivors (p < 0.001). In the RACHS-1 classification, mortality was progressively higher according to the complexity of the procedure, with a 3.24-fold increase in the comparison between groups 6 and 2. The area under the ROC curve for PIM-2 was 0.81 (95%CI 0.75 - 0.87), while for RACHS-1, it was 0.70 (95%CI 0.63 - 0.77). The RACHS presented better calibration power in the sample analyzed. A significantly positive correlation was found between the results of both scores (rs = 0.532; p < 0.001).
Conclusion: RACHS presented good calibration power, and RACHS-1 and PIM-2 demonstrated good performance with regard to their discriminating capacities between survivors and non-survivors. Moreover, a positive correlation was found between the results of the two risk scores.
Databáze: MEDLINE
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