Cardiothoracic & vascular anesthesia
Development and Validation of Scores to Predict Prolonged Mechanical Ventilation after Cardiac Surgery
Authors' conclusion
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.
Study context
- Population
- Patients after cardiac surgery in the and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) database, January 2015–December 2018validation cohort n = 12,229
- Participants
- 48,382 patients
- Exposure
- ANZ-PreVent score vs Modified Hessels score
- Outcome
- Prediction of mechanical ventilation >24 hours
Methodological detailsprediction model development and validation, registry database
- Prediction model development and validation
- Registry database
Main finding
As reported in the abstract
| Group | C-index | Brier score |
|---|---|---|
| Modified Hessels score | 0.78 (95% CI 0.77-0.78) | 0.08 |
| ANZ-PreVent score | 0.84 (95% CI 0.83-0.85) | 0.07 |
C-index
Modified Hessels score0.78 (95% CI 0.77-0.78)
ANZ-PreVent score0.84 (95% CI 0.83-0.85)
Brier score
Modified Hessels score0.08
ANZ-PreVent score0.07
- ANZ-PreVent score vs Modified Hessels score: P < 0.0001 — better performance (validation cohort)
Observational data: associations, not effects.
Further findings
Incidence of mechanical ventilation >24 hours
- Ventilated >24 hours postoperatively
- 5004 (10.3%)
Comparison with ICU severity of illness scores
- Both scores performed better than severity of illness scores commonly used in intensive care
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Development and Validation of Scores to Predict Prolonged Mechanical Ventilation after Cardiac Surgery. J Cardiothorac Vasc Anesth. Published 2 November 2023. doi:10.
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