External Validation of 3 Risk Scores in Adults with Congenital Heart Disease.
Congenital heart defect
Validation studies
Journal
Korean circulation journal
ISSN: 1738-5520
Titre abrégé: Korean Circ J
Pays: Korea (South)
ID NLM: 101247141
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
08
01
2019
revised:
19
02
2019
accepted:
03
04
2019
pubmed:
6
6
2019
medline:
6
6
2019
entrez:
6
6
2019
Statut:
ppublish
Résumé
Adults with congenital heart disease (CHD) are an increasing group of patients thanks to the survival of over 85% of children with CHD. 20% of these patients shall warrant a surgical procedure during their life span. However, currently there is no one risk score that assess correctly the mortality of these procedures. Thus, we analyse the risk scores used at our institution. From May 1991 till June 2017, 608 procedures in adults with CHD were performed. The 3 risk scores (risk adjustment for congenital heart surgery [RACHS-1], Aristotle, and Euroscore I) of each procedure were analysed. We used area under the receiver operating characteristic curve (c-index) to measure model discrimination, and Hosmer-Lemeshow (H-L) statistic along with calibration plots to measure calibration. There was no statistical difference between the area under the curve for the 3 scores (χ²=0.58 with 2 df, p=0.750). There was no evidence of lack of fit for RACHS-1 (H-L, χ²=2.61; p=0.271) and Aristotle score (H-L, χ²=5.69; p=0.459). However, there was evidence in lack of calibration in the Euroscore I scoring system (H-L, χ²=33.69; p<0.001). The calibration slope for RACHS-1 was 0.912, for Aristotle (stratified in risk groups) was -0.14 and for Euroscore 1 (stratified in risk groups) was 0.46. RACHS-1 seems to be best risk scoring system for calculating mortality applied to surgery in adults with CHD.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
Adults with congenital heart disease (CHD) are an increasing group of patients thanks to the survival of over 85% of children with CHD. 20% of these patients shall warrant a surgical procedure during their life span. However, currently there is no one risk score that assess correctly the mortality of these procedures. Thus, we analyse the risk scores used at our institution.
METHODS
METHODS
From May 1991 till June 2017, 608 procedures in adults with CHD were performed. The 3 risk scores (risk adjustment for congenital heart surgery [RACHS-1], Aristotle, and Euroscore I) of each procedure were analysed. We used area under the receiver operating characteristic curve (c-index) to measure model discrimination, and Hosmer-Lemeshow (H-L) statistic along with calibration plots to measure calibration.
RESULTS
RESULTS
There was no statistical difference between the area under the curve for the 3 scores (χ²=0.58 with 2 df, p=0.750). There was no evidence of lack of fit for RACHS-1 (H-L, χ²=2.61; p=0.271) and Aristotle score (H-L, χ²=5.69; p=0.459). However, there was evidence in lack of calibration in the Euroscore I scoring system (H-L, χ²=33.69; p<0.001). The calibration slope for RACHS-1 was 0.912, for Aristotle (stratified in risk groups) was -0.14 and for Euroscore 1 (stratified in risk groups) was 0.46.
CONCLUSIONS
CONCLUSIONS
RACHS-1 seems to be best risk scoring system for calculating mortality applied to surgery in adults with CHD.
Identifiants
pubmed: 31165593
pii: 49.e72
doi: 10.4070/kcj.2019.0015
pmc: PMC6713823
doi:
Types de publication
Journal Article
Langues
eng
Pagination
856-863Informations de copyright
Copyright © 2019. The Korean Society of Cardiology.
Déclaration de conflit d'intérêts
The authors have no financial conflicts of interest.
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