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Estimación del riesgo en cirugía cardiaca en el “Mundo Real”: ArgenSCORE ajustado al centro;
Cardiovascular Surgery Risk Assessment in the “Real World”: ArgenSCORE Adjusted by Center

Creators:Carosella, Victorio, Grancelli, Hugo, Stutzbach, Pablo, Sigal, Alan, Lerech, Ezequiel, Morcos, Ludmila, Villalba, César, Lowenstein Haber, Diego, Hita, Alejandro, Nojek, Carlos
2021-04-20

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Descripción

Introducción: El ArgenSCORE tiene una versión original (I) desarrollada en 1999 sobre una población con mortalidad del 8%y una versión II (recalibración del modelo en 2007) sobre una población con una mortalidad del 4%. Evaluamos en el registroCONAREC XVI la hipótesis de que el ArgenSCORE II podría estimar mejor el riesgo de mortalidad intrahospitalaria en loscentros con baja mortalidad; en cambio, el ArgenSCORE I estimaría mejor la mortalidad en los centros con alta mortalidad.Material y métodos: Se analizaron 2548 pacientes de 44 centros del registro prospectivo y multicéntrico en cirugía cardíaca,CONAREC XVI. En cada centro se evaluó la mortalidad media observada (MO) y se calculó la mortalidad estimada media(ME) aplicando ambas versiones del ArgenSCORE.Se calculó la relación MO/ME de cada centro para los dos modelos y se evaluó si había diferencias significativas mediante eltest Z.Resultados: La mortalidad intrahospitalaria del registro fue del 7,69%. El 75% de los centros (33/44) presentaban una mortalidadmayor del 6%. En centros con mortalidad menor del 6%, al aplicar el ArgenSCORE II, la relación MO/ME mostróvalores cercanos a 1 y sin diferencias significativas. En centros con mortalidad mayor del 6%, el ArgenSCORE II subestimasignificativamente el riesgo. En cambio, cuando se aplica en estos centros el ArgenSCORE I, la relación MO/ME es cercanaa 1 (sin diferencias significativas).Conclusiones: En centros con mortalidad menor del 6%, es recomendable utilizar el ArgenSCORE II-recalibrado; en centroscon mortalidad mayor del 6%, tiene mejor desempeño el ArgenSCORE I-original.

Background: The ArgenSCORE I was developed in 1999 on a population with 8% mortality. The ArgenSCORE II emerged afterrecalibrating the original model in 2007 on a validation population with 4% mortality. Using the CONAREC XVI registry, weevaluated the hypothesis that the ArgenSCORE II could better predict the risk of in-hospital mortality in centers with lowmortality, whereas the ArgenSCORE I could better predict mortality in centers with high mortality.Methods: A total of 2548 patients from 44 centers of the prospective and multicenter cardiac surgery CONAREC XVI registry,were analyzed. Mean observed mortality (OM) and mean expected mortality (EM) were estimated applying both versions ofthe ArgenSCORE.The OM/EM ratio was calculated in each center for both models and the Z test was used to evaluate significant differences.Results: In-hospital mortality was 7.69% for the entire registry. In 75% of the centers (33/44) mortality was &gt;6%. In centerswith mortality &lt;6%, the OM/EM ratio was close to 1 after applying the ArgenSCORE II, without significant differences. Incenters with mortality &gt;6%, the ArgenSCORE II significantly underestimated the risk. On the contrary, when the Argen-SCORE I was applied in these centers, the OM/EM ratio was close to 1, without significant differences.Conclusions: The recalibrated ArgenSCORE II is recommended in centers with mortality &lt;6%, while in those with mortality&gt;6% the original ArgenSCORE I has better performance.

Metadatos destacados

Colecciones
Argentine Journal of Cardiology

Editor

Sociedad Argentina de Cardiología

Fuente

Revista Argentina de Cardiología; Vol 89, No 1 (2021); 3-12, Argentine Journal of Cardiology; Vol 89, No 1 (2021); 3-12

Citación

Carosella, Victorio et al., “Estimación del riesgo en cirugía cardiaca en el “Mundo Real”: ArgenSCORE ajustado al centro,” Archivo PPCT, consulta 2 de abril de 2026, http://archivoppct.caicyt.gov.ar/items/show/9767.

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Materia

Autor

Carosella, Victorio
Grancelli, Hugo
Stutzbach, Pablo
Sigal, Alan
Lerech, Ezequiel
Morcos, Ludmila
Villalba, César
Lowenstein Haber, Diego
Hita, Alejandro
Nojek, Carlos

Fuente

Revista Argentina de Cardiología; Vol 89, No 1 (2021); 3-12
Argentine Journal of Cardiology; Vol 89, No 1 (2021); 3-12

Editor

Sociedad Argentina de Cardiología

Fecha

2021-04-20

Derechos

Los que firman al pié, certificamos que tenemos total responsabilidad por la conducción de este estudio y por el diseño y la interpretación de los datos. Nosotros escribimos el manuscrito y somos responsables por la decisión acerca del mismo. Cada uno de nosotros cumple la definición de autor como se afirma en el Comité Internacional de Editores de Revistas Médicas (International Committee of Medical Journal Editors, ver www.icmje.org). Nosotros hemos visto y aprobado el manuscrito final. Ni el artículo, ni ninguna parte esencial del mismo, incluido las tablas y las figuras, será publicado o admitido para arbitrar a otra parte antes de aparecer en la Revista.También notificamos haber leído la sección “conflicto de intereses”, y revelaríamos cualquiera que existiera. Dejamos constancia que si nuestro artículo se publicara en la RAC, cederíamos los derechos (copyright) a la Revista.Los documentos publicados en esta revista están bajo la licencia Creative Commons Atribución-NoComercial-Compartir-Igual 2.5 Argentina.
Those signing below certify that we have full responsibility for the conduction of this study and for the design and interpretation of the information. We wrote the manuscript and are responsible for its decision. Each of us fulfills the definition of authorship as stated by the International Committee of Medical Journal Editors ( www.icmje.org). We have signed and approved the final manuscript. Neither the manuscript, nor any essential part thereof, including tables and figures, will be published or accepted for refereeing elsewhere before being published in the Journal. We have also read the "Conflict of Interest" section and would disclose any existing. We state that if our manuscript is published in the RAC, we shall transfer the copyright to the Journal.

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Idioma

spa
eng

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info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion