Development of an Iranian CPB Based Risk Stratification Score Model, an Iranian Risk Stratification Model

Abstract

Background: This study evaluates cardiopulmonary bypass (CPB) as a predictor of 30-day postoperative mortality and modifies<br><br>Parsonnet and Euro SCORE models accordingly to develop a new model.<br><br>Methods: Information of 1920 consecutive patients who underwent elective and emergent surgery in our center was collected.<br><br>Parsonnet and Euro SCORE model parameters in addition to 81 variables including perioperative information gathered. Following<br><br>statistical analysis by R software a new model considering CPB under the name of Iranian model was designed. Parsonnet and Euro<br><br>SCORE models were recalibrated and CPB variable was entered. Data validation was performed in 40 consecutive patients.<br><br>Results: P value of our five predictor models including Iranian, Parsonnet (P) and modified Parsonnet (MP), Euro SCORE (ES) and<br><br>modified Euro SCORE (MES) models were &lt; 2e-16. Iranian model has a lower overestimation of mortality (0.4375) and its area under<br><br>curve (AUC) was higher (0.9537). AUCof P,MP, ES andMESmodels were 0.9551, 0.9841, 0.8659 and 0.9465 respectively. Overestimation<br><br>of early post operative mortality of P, MP, ES and MES models were 0.6483, 0.5271, 0.6267 and 0.5056 respectively.<br><br>Conclusions: This study confirmed that CPB as a variable is a predictor of mortality and is applicable in risk stratification models.<br><br>CPB increases AUC and decreases Overestimation of mortality. Iranian model as the first CPB dependent mortality prediction model<br><br>has more accurate mortality estimation in respect to other models.