Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/34584
Title: Development and Validation of Scores to Predict Prolonged Mechanical Ventilation after Cardiac Surgery.
Austin Authors: O'Brien, Zachary ;Bellomo, Rinaldo ;Williams-Spence, Jenni;Reid, Christopher M;Coulson, Tim G 
Affiliation: Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia.
Intensive Care
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Data Analytics Research and Evaluation (DARE) Centre
Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia; Department of Anaesthesia, The Alfred Hospital, Melbourne, Victoria, Australia.
Issue Date: Feb-2024
Date: 2023
Publication information: Journal of Cardiothoracic and Vascular Anesthesia 2024-02; 38(2)
Abstract: To optimize the early prediction of prolonged postoperative mechanical ventilation after cardiac surgery (>24 hours postoperatively). The authors performed a retrospective analysis. The Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) database was utilized. All patients included in the ANZSCTS database between January 2015 and December 2018 were analyzed. No interventions were performed in this observational study. A previously developed model was modified to allow retrospective risk calculation and model assessment (Modified Hessels score). The database was split into development and validation sets. A new risk model was developed using forward and backward stepwise elimination (ANZ-PreVent score). The authors assessed 48,382 patients, of whom 5004 (10.3%) were ventilated mechanically for >24 hours post-operatively. The Modified Hessels score demonstrated good performance in this database, with a c-index of 0.78 (95% CI 0.77-0.78) and a Brier score of 0.08. The newly developed ANZ-PreVent score demonstrated better performance (validation cohort, n = 12,229), with a c-index of 0.84 (95% CI 0.83-0.85) (p < 0.0001) and a Brier score of 0.07. Both scores performed better than the severity of illness scores commonly used to predict outcomes in intensive care. The authors validated a modified version of an existing prediction score and developed the ANZ-PreVent score, with improved performance for identifying patients at risk of ventilation for >24 hours. The improved score can be used to identify high-risk patients for targeted interventions in future randomized controlled trials.
URI: https://ahro.austin.org.au/austinjspui/handle/1/34584
DOI: 10.1053/j.jvca.2023.10.038
ORCID: 
Journal: Journal of Cardiothoracic and Vascular Anesthesia
PubMed URL: 38052694
ISSN: 1532-8422
Type: Journal Article
Subjects: Cardiac surgery
intensive care
mechanical ventilation
risk score
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