title: Applicability of two international risk scores in cardiac surgery in a reference center in Brazil.
abstract: BACKGROUND
  The applicability of international risk scores in heart surgery (HS) is not well defined in centers outside of North America and Europe.
  
  
  OBJECTIVE
  To evaluate the capacity of the Parsonnet Bernstein 2000 (BP) and EuroSCORE (ES) in predicting in-hospital mortality (IHM) in patients undergoing HS at a reference hospital in Brazil and to identify risk predictors (RP).
  
  
  METHODS
  Retrospective cohort study of 1,065 patients, with 60.3% patients underwent coronary artery bypass grafting (CABG), 32.7%, valve surgery and 7.0%, CABG combined with valve surgery. Additive and logistic scores models, the area under the ROC (Receiver Operating Characteristic) curve (AUC) and the standardized mortality ratio (SMR) were calculated. Multivariate logistic regression was performed to identify the RP.
  
  
  RESULTS
  Overall mortality was 7.8%. The baseline characteristics of the patients were significantly different in relation to BP and ES. AUCs of the logistic and additive BP were 0.72 (95% CI, from 0.66 to 0.78 p = 0.74), and of ES they were 0.73 (95% CI; 0.67 to 0.79 p = 0.80). The calculation of the SMR in BP was 1.59 (95% CI; 1.27 to 1.99) and in ES, 1.43 (95% CI; 1.14 to 1.79). Seven RP of IHM were identified: age, serum creatinine > 2.26 mg/dL, active endocarditis, systolic pulmonary arterial pressure > 60 mmHg, one or more previous HS, CABG combined with valve surgery and diabetes mellitus.
  
  
  CONCLUSIONS
  Local scores, based on the real situation of local populations, must be developed for better assessment of risk in cardiac surgery.
authors.forename: Silvia Bueno
authors.initials: SB
authors.lastname: Garofallo
authors.forename: Daniel Pinheiro
authors.initials: DP
authors.lastname: Machado
authors.forename: Clarissa Garcia
authors.initials: CG
authors.lastname: Rodrigues
authors.forename: Odemir
authors.initials: O
authors.lastname: Bordim
authors.forename: Renato A K
authors.initials: RA
authors.lastname: Kalil
authors.forename: Vera Lúcia
authors.initials: VL
authors.lastname: Portal
mesh_terms: D000368:Aged; D001938:Brazil; D001026:Coronary Artery Bypass / Q000401:mortality*; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012016:Reference Values; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity