Details

Autor(en) / Beteiligte

• Sullivan, Patrick G., MD, MS
• Wallach, Joshua D., BA
• Ioannidis, John P.A., MD, DSc

Titel

Meta-Analysis Comparing Established Risk Prediction Models (EuroSCORE II, STS Score and ACEF Score) for Perioperative Mortality during Cardiac Surgery

Ist Teil von

• The American journal of cardiology, 2016-11, Vol.118 (10), p.1574-1582

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2016

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract A wide variety of multivariable risk models have been developed to predict mortality in the setting of cardiac surgery; however, the relative utility of these models is unknown. This study investigated the literature related to comparisons made between established risk prediction models for perioperative mortality used in the setting of cardiac surgery. A systematic review was conducted to capture studies in cardiac surgery comparing the relative performance of at least 2 prediction models cited in recent guidelines (EuroSCORE II, STS score, and ACEF score) for the outcomes of 1-month or in-hospital mortality. For articles that met inclusion criteria, we extracted information on study design, predictive performance of risk models, and potential for bias. Meta-analyses were conducted to calculate a summary estimate of the difference in AUCs between models. We identified 22 eligible studies that contained 33 comparisons between the above models. Meta-analysis of differences in AUCs revealed that the EuroSCORE II and STS score performed similarly (with a summary difference in AUC = 0.00), while outperforming the ACEF score (with summary differences in AUC of 0.10 and 0.08, respectively, p < 0.05). Other metrics of discrimination and calibration were presented less consistently, and no study presented any metric of reclassification. Small sample size and absent descriptions of missing data were common in these studies. In conclusion, the EuroSCORE II and STS score outperform the ACEF score on discrimination.