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| Id: | 13721
| | Author: | Yende, Sachin; Wunderink, Richard
| | Title: | Validity of scoring systems to predict risk of prolonged mechanical ventilation after coronary artery bypass graft surgery
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| | Source: | s.l; s.n; 2002. 6 p. tab, graf.
| | Abstract: | STUDY OBJECTIVE: Two scoring systems, (the Spivack scoring system [SSS] and the cardiac risk score [CRS]), have been proposed to predict the risk of prolonged mechanical ventilation (PMV) after coronary artery bypass graft surgery (CABG). The primary objective of this study was to validate the efficacy of these scoring systems to predict the risk of PMV. DESIGN: Prospective observational study. SETTING: Cardiovascular surgical ICU. PATIENTS: Three hundred forty-eight patients underwent CABG. Following surgery, patients were extubated by a standardized respiratory weaning protocol. MEASUREMENTS AND RESULTS: Forty-nine percent of patients had SSS > 0 and had significantly longer duration of mechanical ventilation. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the SSS for failure to extubate at 48 h are 80, 49, 9 per cent, and 98 per cent, respectively. Two hundred thirty-two patients (67.5 per cent), 101 patients (29 per cent), and 12 patients (3.5 per cent) had a CRS of 0 to 4, 5 to 8, and > 8, respectively. Patients with lower scores had shorter duration of mechanical ventilation. The sensitivity, specificity, PPV, and NPV of the CRS for failure to extubate at 10 h are 42, 73, 47 per cent and 69 per cent, respectively. CONCLUSION: The SSS may be used as a preoperative screening tool. A simple questionnaire that includes history of unstable angina, diabetes, congestive heart failure, and smoking prior to hospital admission can be used to calculate the SSS. Patients with SSS < further without surgery to proceed can and PMV for risk low at are 0>. (AU).
| | Descriptors: | PONTE DE ARTERIA CORONARIA/*
CUIDADOS CRITICOS/*
MORTALIDADE HOSPITALAR
TEMPO DE INTERNACAO
MODELOS LINEARES
PERIODO POS-OPERATORIO
VALOR PREDITIVO DOS TESTES
ESTUDOS PROSPECTIVOS
CURVA ROC
RESPIRACAO ARTIFICIAL/*
DESMAME DO RESPIRADOR
| | Limits: | FEMININO
HUMANO
MASCULINO
MEIA-IDADE
SUPPORT, NON-U.S. GOV'T
| | Location: | BR191.1; 09064/s |
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