Risk stratification in cardiac surgery.
Risk stratification in cardiac surgery is based on different models. The great majority of these models derives from a logistic regression equation, and the resulting risk score attributes a specific value to a number of risk factors. However, the number, definition, and type of risk factors included in each risk score greatly varies. Some of the existing risk models include up to 15-20 risk factors. However, it has been demonstrated that for elective patients a simple risk model based on just three factors (age, creatinine, and ejection fraction) has the same level of accuracy and a much better calibration that more complex models. The main deficiency of all the risk models is that they cannot take into consideration the presence of extreme risk conditions which have a very low prevalence, but which are accompanied by a very high operative mortality rate.
Ranucci
Marco
M
Department of Anesthesiology, San Donato Hospital, Milan, Italy. cardioanestesia@virgilio.it
D000367:Age Factors; D006348:Cardiac Surgical Procedures / Q000401:mortality*; D003404:Creatinine / Q000378:metabolism; D017558:Elective Surgical Procedures / Q000401:mortality*; D006801:Humans; D016015:Logistic Models; D015233:Models, Statistical; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013318:Stroke Volume
D003404:Creatinine