title: Stratification of complexity in congenital heart surgery: comparative study of the Risk Adjustment for Congenital Heart Surgery (RACHS-1) method, Aristotle basic score and Society of Thoracic Surgeons-European Association for Cardio- Thoracic Surgery (STS-EACTS) mortality score.
abstract: OBJECTIVE
  To determine whether stratification of complexity models in congenital heart surgery (RACHS-1, Aristotle basic score and STS-EACTS mortality score) fit to our center and determine the best method of discriminating hospital mortality.
  
  
  METHODS
  Surgical procedures in congenital heart diseases in patients under 18 years of age were allocated to the categories proposed by the stratification of complexity methods currently available. The outcome hospital mortality was calculated for each category from the three models. Statistical analysis was performed to verify whether the categories presented different mortalities. The discriminatory ability of the models was determined by calculating the area under the ROC curve and a comparison between the curves of the three models was performed.
  
  
  RESULTS
  360 patients were allocated according to the three methods. There was a statistically significant difference between the mortality categories: RACHS-1 (1) - 1.3%, (2) - 11.4%, (3)-27.3%, (4) - 50 %, (P<0.001); Aristotle basic score (1) - 1.1%, (2) - 12.2%, (3) - 34%, (4) - 64.7%, (P<0.001); and STS-EACTS mortality score (1) - 5.5 %, (2) - 13.6%, (3) - 18.7%, (4) - 35.8%, (P<0.001). The three models had similar accuracy by calculating the area under the ROC curve: RACHS-1- 0.738; STS-EACTS-0.739; Aristotle- 0.766.
  
  
  CONCLUSIONS
  The three models of stratification of complexity currently available in the literature are useful with different mortalities between the proposed categories with similar discriminatory capacity for hospital mortality.
authors.affiliation: Universidade de Pernambuco, Recife, PE, Brazil.
authors.forename: Paulo Ernando Ferraz
authors.initials: PE
authors.lastname: Cavalcanti
authors.affiliation: Universidade de Pernambuco, Recife, PE, Brazil.
authors.forename: Michel Pompeu Barros de Oliveira
authors.initials: MP
authors.lastname: Sá
authors.affiliation: Universidade de Pernambuco, Recife, PE, Brazil.
authors.forename: Cecília Andrade dos
authors.initials: CA
authors.lastname: Santos
authors.affiliation: Universidade de Pernambuco, Recife, PE, Brazil.
authors.forename: Isaac Melo
authors.initials: IM
authors.lastname: Esmeraldo
authors.affiliation: Universidade de Pernambuco, Recife, PE, Brazil.
authors.forename: Mariana Leal
authors.initials: ML
authors.lastname: Chaves
authors.affiliation: Universidade de Pernambuco, Recife, PE, Brazil.
authors.forename: Ricardo Felipe de Albuquerque
authors.initials: RF
authors.lastname: Lins
authors.affiliation: Universidade de Pernambuco, Recife, PE, Brazil.
authors.forename: Ricardo de Carvalho
authors.initials: Rde C
authors.lastname: Lima
mesh_terms: D000293:Adolescent; D001938:Brazil; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000401:mortality* / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D011787:Quality of Health Care; D012372:ROC Curve; D012016:Reference Values; D015203:Reproducibility of Results; D012189:Retrospective Studies; D020379:Risk Adjustment / Q000379:methods*; D012955:Societies, Medical; D016896:Treatment Outcome