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. 2023 Jul 27;31(3):343-351.
doi: 10.5606/tgkdc.dergisi.2023.24787. eCollection 2023 Jul.

CASUS and APACHE II score in predicting mortality after coronary artery bypass grafting

Sümeyye Uğur  1 , Murat Acarel  1 , Nihan Yapıcı  1
Affiliations

CASUS and APACHE II score in predicting mortality after coronary artery bypass grafting

Sümeyye Uğur et al. Turk Gogus Kalp Damar Cerrahisi Derg. .

Abstract

Background: This study aims to compare Cardiac Surgery Score (CASUS) and the Acute Physiology and Chronic Health Evaluation (APACHE II) scoring systems for predicting mortality in patients undergoing isolated coronary artery bypass grafting.

Methods: Between January 2019 and March 2019, a total of 204 patients (166 males, 38 females; mean age: 60.5±0.7 years; range, 59.2 to 61.9 years) who underwent isolated coronary artery bypass grafting and were monitored at least for 24 h in the intensive care unit postoperatively were included. Pre-, intra-, and postoperative data were recorded. The CASUS and APACHE II scores were calculated using the most abnormal values for each variable during the first 24 h, postoperatively. Clinical outcomes were seven-day mortality and 30-day mortality, need for reintubation, readmission to the intensive care unit, length of intensive care unit stay and length of hospital stay.

Results: The 30-day overall mortality was 4.9% (n=10). The CASUS scores were significantly higher for patients developing mortality within 30 days postoperatively (p=0.030) and for patients needing reintubation (p=0.003). In the receiver operating characteristic curve analysis predicting seven-day mortality and prolonged intensive care unit stay, the area under curve was higher for CASUS scoring compared to APACHE II (0.90 vs. 0.72 and 0.82 vs. 0.76).

Conclusion: The CASUS may prove to be a more reliable scoring system than APACHE II for predicting mortality and morbidity in patients undergoing isolated coronary artery bypass grafting.

Keywords: APACHE II; CASUS; cardiac surgery; mortality..

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Conflict of interest statement

Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Figures

Figure 1
Figure 1. ROC of EuroSCORE, CASUS and APACHE II score concerning 30-day mortality. ROC: Receiver operating characteristic; EuroSCORE: European System for Cardiac Operative Risk; APACHE II: Acute Physiology and Chronic Health Evaluation; CASUS: Cardiac Surgery Score.
Figure 2
Figure 2. ROC of EuroSCORE, CASUS and APACHE II score concerning 7-day mortality. ROC: Receiver operating characteristic; EuroSCORE: European System for Cardiac Operative Risk; APACHE II: Acute Physiology and Chronic Health Evaluation; CASUS: Cardiac Surgery Score.
Figure 3
Figure 3. ROC of CASUS and APACHE II concerning ICU stay. ROC: Receiver operating characteristic; EuroSCORE: European System for Cardiac Operative Risk; APACHE II: Acute Physiology and Chronic Health Evaluation; CASUS: Cardiac Surgery Score.
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