Medizinische Universität Graz - Research portal
Selected Publication:
Zobel, G; Rödl, S; Rigler, B; Metzler, H; Dacar, D; Grubbauer, HM; Beitzke, A.
Prospective evaluation of clinical scoring systems in infants and children with cardiopulmonary insufficiency after cardiac surgery.
J Cardiovasc Surg (Torino). 1993; 34(4):333-337
Web of Science
PubMed
- Co-authors Med Uni Graz
- Metzler Helfried
- Rigler Bruno
- Roedl Siegfried
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- Abstract:
- OBJECTIVE. To document severity of illness and to evaluate the predictive value of clinical scoring systems in infants and children with cardiopulmonary insufficiency after cardiac surgery. DESIGN. Prospective study with follow up to hospital discharge. SETTING. A multidisciplinary pediatric ICU in a University Hospital. PATIENTS. Between 1/1989 and 4/1992 441 infants and children with congenital heart disease underwent open heart surgery. 128 of these patients developed postoperative cardiopulmonary insufficiency and were entered into this study. METHODS. Data relevant to the Acute Physiologic Score for Children (APSC), Pediatric Risk of Mortality (PRISM), Therapeutic Intervention Scoring System (TISS) and Organ System Failure (OSF) score were collected in all patients during the first 4 days of postoperative intensive care. RESULTS. The mean age of the patients was 1.5 +/- 0.2 years. The mean duration of mechanical ventilation and ICU care was 6.2 +/- 0.6 and 8.1 +/- 0.7 days, respectively. On the first postoperative day the mean APSC and PRISM scores of survivors and nonsurvivors were 13.9 +/- 1.3 vs 24.5 +/- 1.3 (p < 0.001) and 6.1 +/- 0.5 vs 19.6 +/- 1.9 (p < 0.001), respectively. The mean TISS and OSF scores of survivors and nonsurvivors were 46 +/- 0.8 vs 57.8 +/- 1.4 (p < 0.001), and 2.2 +/- 0.2 vs 3.4 +/- 0.2 (p < 0.001), respectively. The overall hospital mortality rate was 9.9%, the hospital mortality rate of patients with postoperative cardiopulmonary insufficiency 34%. Patients with an APSC score < 10 and a PRISM score < 5 had a survival rate of 100%, whereas patients with an APSC score > 30 and a PRISM score > 25 had a mortality rate of 100%. The area under the receiver operating characteristic (ROC) curve for APSC, PRISM and TISS was 0.847, 0.826 and 0.793, respectively. CONCLUSION. APSC, PRISM and TISS describe accurately severity of illness in infants and children with cardiopulmonary insufficiency after cardiac surgery and all scores identify those patients at increased risk for mortality.
- Find related publications in this database (using NLM MeSH Indexing)
- Cardiac Output, Low - classification
- Child, Preschool - classification
- Evaluation Studies as Topic - classification
- Female - classification
- Heart Defects, Congenital - surgery
- Hospital Mortality - surgery
- Humans - surgery
- Infant - surgery
- Intensive Care Units, Pediatric - surgery
- Male - surgery
- Postoperative Complications - classification
- Prognosis - classification
- Prospective Studies - classification
- ROC Curve - classification
- Respiratory Insufficiency - classification
- Sensitivity and Specificity - classification
- Severity of Illness Index - classification
- Find related publications in this database (Keywords)
- HEART SURGERY
- INFANT
- CHILD
- OUTCOME AND PROGNOSIS
- INTENSIVE CARE, POSTOPERATIVE
- SEVERITY OF ILLNESS INDEX