Validation of a new surgical risk score for heart valve surgery: VMCP.
BACKGROUND
Some studies have developed scores for the assessment of surgical risk, particularly the EuroSCORE, which, however, is complex and difficult to apply. We suggest a new and simpler score, which is more appropriate for the clinical practice and for the assessment of surgical risk in patients with heart valve diseases.


OBJECTIVE
This study was conducted to create and validate a simple and practical score to predict mortality and morbidity related to heart valve surgery.


METHODS
Hospital data from 764 patients were collected, and the score was validated using two statistical models: death (= mortality) and length of hospital stay (LHS) > 10 days (= morbidity). The score was composed by four indexes (V [heart valve lesion], M [myocardial function], C [coronary artery disease], and P [pulmonary artery pressure]). A cut-off point was set for the score, and uni and multivariate analyses were performed to confirm whether the score would be able to predict mortality and morbidity. The existence of association with other risk factors was also studied.


RESULTS
The score was validated with good internal consistency (0.65), and the best cut-off point for mortality and morbidity was 8. Scores > 8 can predict LHS > 10 days (odds ratio [OR] = 1.7; p = 0.006) and a higher death risk, at least in the univariate analysis (p = 0.049). However, the death risk could not be predicted in the multivariate analysis (p=0.258).


CONCLUSIONS
VMCP scores > 8 can predict LHS > 10 days and may be used as a new tool for the follow-up of patients with heart valve disease undergoing surgery.
Grinberg
Max
M
Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Jonke
Vívian Masutti
VM
Sampaio
Roney Orismar
RO
Spina
Guilherme Sobreira
GS
Tarasoutchi
Flavio
F
D001938:Brazil / Q000453:epidemiology; D006348:Cardiac Surgical Procedures / Q000401:mortality*; D004812:Epidemiologic Methods; D005260:Female; D006349:Heart Valve Diseases / Q000453:epidemiology / Q000601:surgery; D006351:Heart Valves / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment / Q000379:methods / Q000592:standards; D012307:Risk Factors