Age,Creatinine and Ejection Fraction Score in Brazil: Comparison with InsCor and the EuroSCORE

Background

Risk scores for cardiac surgery cannot continue to be neglected.

Objective

To assess the performance of “Age, Creatinine and Ejection Fraction Score” (ACEFScore) to predict mortality in patients submitted to elective coronary arterybypass 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 Braziliantertiary care center. A total of 2,565 patients submitted to elective surgeriesbetween May 2007 and July 2009 were assessed. For a more detailed analysis, theACEF Score performance was compared to the InsCor’s and EuroSCORE’s performancethrough 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 ROCcurve was questionable for the ACEF Score (0.625) and adequate for InsCor (0.744)and EuroSCORE (0.763).

Conclusion

Although simple to use and practical, the ACEF Score, unlike InsCor and EuroSCORE,was not accurate for predicting mortality in patients submitted to electivecoronary artery bypass graft and/or heart valve surgery in a Brazilian tertiarycare center.