Article (Scientific journals)
Development and Validation of a Prediction Score for Low-Cardiac-Output Syndrome After Adult Cardiac Surgery.
Mendes, Manuel Azevedo; Fabre, Marie; AMABILI, Philippe et al.
2023In Journal of Cardiothoracic and Vascular Anesthesia
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Keywords :
adult cardiac surgery; inotropes; low-cardiac-output syndrome; prediction score; Cardiology and Cardiovascular Medicine; Anesthesiology and Pain Medicine
Abstract :
[en] [en] OBJECTIVES: The authors aimed to develop a simple prediction score to help identify patients at high risk of low-cardiac-output syndrome after adult cardiac surgery. DESIGN: A single-center, retrospective, observational study. SETTING: At a tertiary hospital. PARTICIPANTS: Adult patients who underwent on-pump cardiac surgery between April 2016 and March 2021. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: Among the 2,806 patients retained for final analyses, 355 (12.7%) developed low-cardiac-output syndrome. Using a stepwise backward variable selection procedure applied to a multivariate logistic regression, a prediction model, including 8 risk factors, could be identified-preoperative left ventricular ejection fraction, glomerular filtration rate <60 mL/min according to the Cockcroft formula or preoperative dialysis, combined surgery, nonelective surgery, mitral valve surgery for mitral valve regurgitation, history of extracardiac arteriopathy, preoperative hemoglobin <13 g/dL, and New York Heart Association functional class III or IV. A clinical prediction score was derived from the regression coefficients. The model had a good discriminative ability, with an area under the receiver operating characteristics curve of 0.8 (95% CI: 077-0.84). Using a threshold value of 5, the score had a 68% sensitivity, 79% specificity, a positive-predictive value of 33%, and a negative-predictive value of 94%. These results were validated on a validation sample using the bootstrap resampling technique. CONCLUSIONS: The authors developed a clinical score to facilitate the prediction of low- cardiac-output syndrome after adult cardiac surgery. This could help tailor patient management by contributing to the early identification of those at high risk of postoperative low cardiac output.
Disciplines :
Anesthesia & intensive care
Author, co-author :
Mendes, Manuel Azevedo ;  Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium. Electronic address: m.mendes@chuliege.be
Fabre, Marie ;  Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation
AMABILI, Philippe ;  Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation
Jaquet, Océane ;  Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation
Donneau, Anne-Françoise ;  Université de Liège - ULiège > Département des sciences de la santé publique
Bonhomme, Vincent  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation
Hans, Grégory  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation
Language :
English
Title :
Development and Validation of a Prediction Score for Low-Cardiac-Output Syndrome After Adult Cardiac Surgery.
Publication date :
19 June 2023
Journal title :
Journal of Cardiothoracic and Vascular Anesthesia
ISSN :
1053-0770
eISSN :
1532-8422
Publisher :
W.B. Saunders, United States
Peer reviewed :
Peer Reviewed verified by ORBi
Funding text :
The authors would like to thank Mrs. Jacques and Mrs Thys from the “Service des informations médico économiques” of the CHU of Liège for their valuable help in the data collection.
Available on ORBi :
since 22 August 2023

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