title: Age, Creatinine and Ejection Fraction Score in Brazil: Comparison with InsCor and the EuroSCORE.
abstract: BACKGROUND
  Risk scores for cardiac surgery cannot continue to be neglected.
  
  
  OBJECTIVE
  To assess the performance of "Age, Creatinine and Ejection Fraction Score" (ACEF Score) to predict mortality in patients submitted to elective coronary artery bypass graft and/or heart valve surgery, and to compare it to other scores.
  
  
  METHODS
  A prospective cohort study was carried out with the database of a Brazilian tertiary care center. A total of 2,565 patients submitted to elective surgeries between May 2007 and July 2009 were assessed. For a more detailed analysis, the ACEF Score performance was compared to the InsCor's and EuroSCORE's performance through correlation, calibration and discrimination tests.
  
  
  RESULTS
  Patients were stratified into mild, moderate and severe for all models. Calibration was inadequate for ACEF Score (p = 0.046) and adequate for InsCor (p = 0.460) and EuroSCORE (p = 0.750). As for discrimination, the area under the ROC curve was questionable for the ACEF Score (0.625) and adequate for InsCor (0.744) and EuroSCORE (0.763).
  
  
  CONCLUSIONS
  Although simple to use and practical, the ACEF Score, unlike InsCor and EuroSCORE, was not accurate for predicting mortality in patients submitted to elective coronary artery bypass graft and/or heart valve surgery in a Brazilian tertiary care center.
authors: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors: Omar Asdrúbal Vilca
authors: OA
authors: Mejía
authors: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors: Bruna La Regina
authors: BL
authors: Matrangolo
authors: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors: David Provenzale
authors: DP
authors: Titinger
authors: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors: Leandro Batisti de
authors: LB
authors: Faria
authors: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors: Luís Roberto Palma
authors: LR
authors: Dallan
authors: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors: Filomena Regina Barbosa
authors: FR
authors: Galas
authors: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors: Luiz Augusto Ferreira
authors: LA
authors: Lisboa
authors: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors: Luís Alberto Oliveira
authors: LA
authors: Dallan
authors: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors: Fabio Biscegli
authors: FB
authors: Jatene
mesh_terms: D000367:Age Factors; D000368:Aged; D001938:Brazil; D002138:Calibration; D001026:Coronary Artery Bypass / Q000401:mortality*; D003404:Creatinine / Q000097:blood*; D017558:Elective Surgical Procedures / Q000401:mortality; D004812:Epidemiologic Methods; D005260:Female; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D012016:Reference Values; D018570:Risk Assessment / Q000379:methods*; D012720:Severity of Illness Index; D013318:Stroke Volume / Q000502:physiology*; D062606:Tertiary Care Centers / Q000706:statistics & numerical data
chemical_list: D003404:Creatinine