title: Gastrointestinal complications after cardiac surgery - improved risk stratification using a new scoring model.
abstract: Gastrointestinal (GI) complications are serious consequences of cardiac surgery. The aim of this study was to develop, evaluate and validate a new risk score model for GI complications after cardiac surgery. The risk score model, named gastrointestinal complication score (GICS), was developed using prospectively collected data from 5593 patients who underwent 5636 cardiac surgical procedures between 1996 and 2001. The model was validated on 1031 cardiac surgery patients between 2005 and 2006. The scoring system's ability to predict GI complications was estimated by receiver operating characteristic (ROC)-curves and Hosmer-Lemeshow test. Fifty GI complications were identified in 47 patients (0.8%) in the developmental data set and eight (0.8%) in the validation data set. The ROC area in the developmental data set was 0.81 with a good calibration estimated by Hosmer-Lemeshow test (P=0.89). In the validation data set, the area under the curve was 0.83. The estimated probability for the patient to develop a GI complication after cardiac surgery at a GICS >or=15 is >20% and at a GICS <or=5 is <0.4%. Risk stratification according to GICS, specifically developed to predict GI complications after cardiac surgery, showed a good predictive ability.
authors.affiliation: Department of Surgery, Lund University and Lund University Hospital, Lund, Sweden.
authors.forename: Bodil
authors.initials: B
authors.lastname: Andersson
authors.forename: Roland
authors.initials: R
authors.lastname: Andersson
authors.forename: Johan
authors.initials: J
authors.lastname: Brandt
authors.forename: Peter
authors.initials: P
authors.lastname: Höglund
authors.forename: Lars
authors.initials: L
authors.lastname: Algotsson
authors.forename: Johan
authors.initials: J
authors.lastname: Nilsson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors