Abstract
Background Our purpose was to evaluate and compare the accuracy of the “Sequential Organ Failure
Assessment” score (SOFA) and the “Cardiac Surgery Score” (CASUS) for the prediction
of mortality after cardiac surgery.
Methods Between January 1, 2007 and December 31, 2008 we prospectively included all consecutive
adult patients admitted to our intensive care unit (ICU) after cardiac surgery. Both
scoring systems were calculated daily from the 1st day in the ICU (day of operation)
until the 7th ICU day. We evaluated the ICU mortality prediction of both models using
calibration and discrimination statistics.
Results 2801 patients (29.6% females) were included. Mean age was 66.9 ± 10.7 years. Intensive
care unit mortality was 5.2%. The calibration of the “Sequential Organ Failure Assessment
Score” and “Cardiac Surgery Score” was reliable for all days (p ≥ 0.05). CASUS was more accurate in predicting survival and mortality compared to
SOFA for all days, as evidenced by the larger areas under the Receiver Operating Characteristic
curves.
Conclusions Both CASUS and SOFA are reliable mortality prediction tools after cardiac surgery.
However, CASUS was more accurate in predicting the individual patient's risk of mortality.
Thus, use of the CASUS in cardiac surgery intensive care units is recommended.
Key words
outcomes (includes mortality morbidity) - intensive care - scoring system - cardiac
surgery - mortality prediction
