Heidelberg Score: A New Simple Risk Assessment Model for Nonelective Coronary Artery Bypass Grafting

Background: The objective was, to create a simple and well performing model that could predict the risk of 30-day mortality in patients who undergo urgent or emergent coronary artery bypass grafting (CABG).

Method: Between 2008 and 2015, a total of 664 patients underwent an isolated non-elective CABG in our institution. We created and cross-validated a logistic regression model for predicting the 30-day mortality, calling it the Heidelberg score. The already existing models (EuroSCOREs, Parsonnet score, KCH score, and ACEF score) were validated and we could compare their performance with our model.

Results: The Heidelberg score consists of two variables: estimated glomerular filtration rate [mL/min/1.73 m²] with the odds ratio = 0.975 and symptomatology of the acute heart failure, graded from 1 to 5, with odds ratio = 1.867. The performance measured with area under receiver operating characteristics curve (AU-ROC) and the goodness of fit were remarkably better than of other commonly used models. The results of validations are shown in the table.

Conclusion: Heidelberg score can predict the 30-day mortality in patients who undergo bypass surgery due to acute coronary syndromes more precisely than other commonly used models. Its maximal simplification allows a fast and wide application.

Score	AU-ROC	Hosmer–Lemeshow test (p-Value)
Heidelberg score	0.81	0.678
Parsonnet score	0.64	0.019
Additive EuroSCORE	0.66	0.042
Logistic EuroSCORE	0.65	0.398
EuroSCORE II	0.64	<0.001
KCH score	0.66	0.105
ACEF score	0.61	0.082

Publikationsverlauf

Artikel online veröffentlicht:
28. Januar 2023