Thorac Cardiovasc Surg 2011; 59 - eP159
DOI: 10.1055/s-0030-1269387

Performance of the German isolated coronary artery bypass surgery preoperative score (KCH) in comparison to logistic-EuroSCORE

A Badreldin 1, T Lehmann 2, J Gummert 3, T Doenst 1, K Hekmat 1
  • 1Friedrich Schiller Universitätsklinikum Jena, Klinik für Herz- und Thoraxchirurgie, Jena, Germany
  • 2Friedrich Schiller Universitätsklinikum Jena, Institut für Medizinische Statistik, Informatik und Dokumentation, Jena, Germany
  • 3Herz- und Diabeteszentrum Nordrhein-Westfalen, Abteilung für Thorax- und Kardiovaskularchirurgie, Bad Oeynhausen, Germany

Aims: Our purpose was to perform an external validation of the German isolated coronary bypass surgery preoperative logistic scoring system (KCH) and to compare it with the logistic EuroSCORE.

Methods: Between January 1st 2007 and December 31st 2008 we included all consecutive adult patients admitted to our intensive care unit after isolated coronary bypass surgery. The three versions of scoring systems were calculated upon admission. The outcome was defined as 30-days mortality. Performance was assessed with the Hosmer-Lemeshow goodness-of-fit test and receiver operating characteristic (ROC) curves. Comparison of ROC curves was performed using the method of DeLong.

Results: 1461 patients (23.96% females) were included. Mean age was 66.9±9.4 years. 30-days mortality was 2.87%. The observed/predicted mortality of Logistic EuroSCORE was 0.32, of KCH 1.0 was 0.55, of KCH 2.0 was 0.72 and of KCH 3.0 was 0.74. Although the discrimination of all four models was comparable, the KCH 3.0 was collectively more reliable in preoperative mortality risk prediction.

Conclusions: KCH 3.0 is the most reliable preoperative mortality prediction score. It is a specific score for the isolated coronary bypass surgery patients in Germany. Further optimization is recommended.