1. Designing a new scoring system (QualyP Score) correlating the management of cardiopulmonary bypass to postoperative outcomes
- Author
-
S D’Aleo, I Milazzo, C Sferrazzo, Antonio Rubino, Carmelo Mignosa, D Giammona, R Busà, S Torrisi, Khalil Fattouch, Carlo Mariani, Rubino, A, Torrisi, S., Milazzo, I., Fattouch, K., Busà, R., Mariani, C., D'Aleo, S., Giammona, D., Sferrazzo, C., Mignosa, C., and AS. Rubino, S. Torrisi, I. Milazzo, K. Fattouch, R. Busà, C.Mariani, S. D’Aleo, D Giammona, C. Sferrazzo, C. Mignosa
- Subjects
Male ,medicine.medical_specialty ,Scoring system ,risk score ,perfusion ,law.invention ,Postoperative Complications ,Predictive Value of Tests ,law ,Cardiopulmonary bypass ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Lactic Acid ,Prospective Studies ,Intensive care medicine ,Aged ,Retrospective Studies ,Advanced and Specialized Nursing ,Cardiopulmonary Bypass ,Framingham Risk Score ,business.industry ,General Medicine ,Carbon Dioxide ,Middle Aged ,quality ,Female ,Cardiology and Cardiovascular Medicine ,business ,Safety Research ,Biomarkers - Abstract
Aim: The aim of this study was to ascertain if a score, directly derived from CPB records, could correlate to major postoperative outcomes. Methods: An additive score (QualyP Score) was created from 10 parameters: peak lactate value during CPB, peak VCO2i, lowest DO2i/VCO2i, peak respiratory quotient, CPB time, cross-clamp time, lowest CPB temperature, circulatory arrest, ultrafiltration during CPB, number of packed red cells transfused intraoperatively. The PerfSCORE was calculated, as well. Multivariable logistic regression models were built to detect the independent predictors of: peak lactate >3 mmol/L during the first three postoperative days; the incidence of acute kidney injury network (AKIN) 1-2-3; respiratory insufficiency; mortality. Results: The mean score was 4.8±2.6 (0-10). A QualyP Score ≥1 was predictive of postoperative acidosis (OR=1.595). A score ≥2 was predictive of AKIN 2 (OR=1.268) and respiratory insufficiency (OR=1.526). A score ≥5 was predictive of AKIN 3 (OR=1.848) and mortality (OR=1.497). Conclusions: QualyP Score may help to provide a quality marker of perfusion, emphasizing the need for goal-directed perfusion strategies.
- Published
- 2015