caa a22 4500 445373865 CHVBK 20180317142956.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s00540-011-1162-z doi (NATIONALLICENCE)springer-10.1007/s00540-011-1162-z Evaluation of Estimation of Physiologic Ability and Surgical Stress to predict in-hospital mortality in cardiac surgery [Elektronische Daten] [Atsushi Kotera, Yoshio Haga, Junichi Kei, Minoru Okamoto, Katsuhiro Seo] Purpose: Prediction of postoperative risk in cardiac surgery is important for cardiac surgeons and anesthesiologists. We generated a prediction rule for elective digestive surgery, designated as Estimation of Physiologic Ability and Surgical Stress (E-PASS). This study was undertaken to evaluate the accuracy of E-PASS in predicting postoperative risk in cardiac surgery. Methods: We retrospectively collected data from patients who underwent elective cardiac surgery at a low-volume center (N=291) and at a high-volume center (N=784). Data were collected based on the variables required by E-PASS, the European system for cardiac operative risk evaluation (EuroSCORE), and the Ontario Province Risk Score (OPRS). Calibration and discrimination were assessed by the Hosmer-Lemeshow test and the area under the receiver operating characteristic curve (AUC), respectively. The ratio of observed-to-estimated in-hospital mortality rates (OE ratio) was defined as a measure of quality. Results: In-hospital mortality rates were 7.6% at the low-volume center and 1.3% at the high-volume center, accounting for an overall mortality rate of 3.0%. AUC values to detect in-hospital mortality were 0.88 for E-PASS, 0.77 for EuroSCORE, and 0.71 for OPRS. Hosmer-Lemeshow analysis showed a good calibration in all models (P=0.81 for E-PASS, P=0.49 for EuroSCORE, and P=0.94 for OPRS). OE ratios for the low-volume center were 0.83 for E-PASS, 0.70 for EuroSCORE, and 0.83 for OPRS, whereas those for the high-volume center were 0.26 for E-PASS, 0.14 for EuroSCORE, and 0.27 for OPRS. Conclusions: E-PASS may accurately predict postoperative risk in cardiac surgery. Because the variables are different between cardiac-specific models and E-PASS, patients' risks can be double-checked by cardiac surgeons using cardiac-specific models and by anesthesiologists using E-PASS. Japanese Society of Anesthesiologists, 2011 Cardiac surgery nationallicence Mortality nationallicence Prediction nationallicence Kotera Atsushi Department of Anesthesiology, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, 860-0008, Kumamoto, Japan aut Haga Yoshio Institute for Clinical Research, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan aut Kei Junichi Department of Cardiac and Vascular Surgery, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan aut Okamoto Minoru Department of Cardiac and Vascular Surgery, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan aut Seo Katsuhiro Department of Anesthesiology, Kokura Memorial Hospital, Fukuoka, Japan aut Journal of Anesthesia Springer Japan 25/4(2011-08-01), 481-491 0913-8668 25:4<481 2011 25 540 https://doi.org/10.1007/s00540-011-1162-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-011-1162-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kotera Atsushi Department of Anesthesiology, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, 860-0008, Kumamoto, Japan aut NATIONALLICENCE 700 1- Haga Yoshio Institute for Clinical Research, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan aut NATIONALLICENCE 700 1- Kei Junichi Department of Cardiac and Vascular Surgery, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan aut NATIONALLICENCE 700 1- Okamoto Minoru Department of Cardiac and Vascular Surgery, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan aut NATIONALLICENCE 700 1- Seo Katsuhiro Department of Anesthesiology, Kokura Memorial Hospital, Fukuoka, Japan aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/4(2011-08-01), 481-491 0913-8668 25:4<481 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer