Cited by 130Cardiac Valve Diseases and TreatmentsCardiac, Anesthesia and Surgical OutcomesCardiac and Coronary Surgery Techniques

Prediction Models for Prolonged Intensive Care Unit Stay After Cardiac Surgery: Systematic Review and Validation Study

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Ettema, Roelof G.A., Peelen, Linda M., Schuurmans, Marieke J., Nierich, Arno P., Kalkman, Cor J., Moons, Karel G.M.·2010·Circulation

Abstract

Background— Several models have been developed to predict prolonged stay in the intensive care unit (ICU) after cardiac surgery. However, no extensive quantitative validation of these models has yet been conducted. This study sought to identify and validate existing prediction models for prolonged ICU length of stay after cardiac surgery. Methods and Results— After a systematic review of the literature, the identified models were applied on a large registry database comprising 11 395 cardiac surgical interventions. The probabilities of prolonged ICU length of stay based on the models were compared with the actual outcome to assess the discrimination and calibration performance of the models. Literature review identified 20 models, of which 14 could be included. Of the 6 models for the general cardiac surgery population, the Parsonnet model showed the best discrimination (area under the receiver operating characteristic curve=0.75 [95% confidence interval, 0.73 to 0.76]), followed by the European system for cardiac operative risk evaluation (EuroSCORE) (0.71 [0.70 to 0.72]) and a model by Huijskes and colleagues (0.71 [0.70 to 0.73]). Most of the models showed good calibration. Conclusions— In this validation of prediction models for prolonged ICU length of stay, 2 widely implemented models (Parsonnet, EuroSCORE), although originally designed for prediction of mortality, were superior in identifying patients with prolonged ICU length of stay.

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  1. Ouattara A, Niculescu M, Boccara G, Landi M, Vaissier E, Le ´ger P, Riou B, Gandjbakch I, Coriat P. Identification of risk factors for allogenic transfusion in cardiac surgery from an observational study. Ann Fr Anesth Reanim. 2003;22:278 -283.
  2. Laupacis A, Sekar N, Stiell IG. Clinical prediction rules: a review and suggested modifications of methodological standards. JAMA. 1997;277:488-494.
  3. Harrell FE Jr. Regression Modelling Strategies. New York, NY: Springer; 2001.

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Authors
Ettema, R. G. A., Peelen, L. M., Schuurmans, M. J., Nierich, A. P., Kalkman, C. J., & Moons, K. G. M.
Affiliations
University of Applied Sciences Utrecht (NL)
Venue
Circulation
Published
2010-08-17
Volume
122
Issue
7
Pages
682-689
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
OpenAlex
W1998435896
Cited by
130
References
52
Citations by year
2026: 2 · 2025: 6 · 2023: 9 · 2022: 6 · 2021: 11 · 2020: 6 · 2019: 4 · 2018: 8 · 2017: 7 · 2016: 8 · 2015: 14 · 2014: 15 · 2013: 15 · 2012: 9
FWCI
7.38
Type
journal article
Language
en
Open access
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
  • Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
Keywords
cardiac surgery, prediction model, model validation, EuroSCORE, model discrimination, model calibration, postoperative outcomes
MeSH terms
Aged, Female, Cardiac Surgical Procedures, Humans, Intensive Care Units, Length of Stay, Male, Middle Aged, Postoperative Period, Predictive Value of Tests, Risk Factors, Time Factors, Models, Statistical, Treatment Outcome

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