A first postoperative day predictive score of mortality for cardiac surgery.

Purpose: Several prognostic scores for cardiac surgery based on preoperative variables are available. We propose a new one based on pre-and intraoperative and first postoperative day variables for cardiac surgery patients admitted to a surgical intensive care unit.

Materials And Methods: Classical cohort of data consecutively collected from June 2000 to March 2003 (1,458 patients). Forty-six risk variables were identified. The statistical study comprised univariate analysis followed by logistic regression with receiver operating characteristics (ROC) curve.

Results: After logistic regression, the selected variables and respective odds ratios were: age >65 and <75 years (2.05); age >/=75 years (4.79); left atrial diameter >45 mm (2.58); preoperative creatinine >2 mg/dL (4.84); and cardiopulmonary bypass time >/=180 min (4.93+/-2). The first postoperative day variables were as follows: the worst PaO(2)/FiO(2) <100 (9.47); epinephrine or norepinephrine dose >/=0.1 microg/kg/min (6.78); and mechanical ventilation time >12 h (2.24). The area under the ROC curve was 0.84.

Conclusion: The score shows the strength of first postoperative day variables, probably related to intraoperative conditions. It also evidences the importance of left atrial diameter as a new marker of preoperative risk.