Designing a new scoring system (QualyP Score) correlating the management of cardiopulmonary bypass to postoperative outcomes. (September 2015)

• Record Type: Journal Article
• Authors: Rubino, AS; Torrisi, S; Milazzo, I; Fattouch, K; Busà, R; Mariani, C; D'Aleo, S; Giammona, D; Sferrazzo, C; Mignosa, C
• Is Part Of: Perfusion. Volume 30:Number 6(2015)
• Page Start: 448
• Page End: 456
• Publication Date: 2015-09
• Subjects: perfusion -- quality -- risk score; Perfusion (Physiology) -- Periodicals; Blood -- Circulation, Artificial -- Periodicals; Heart -- Surgery -- Periodicals; Extracorporeal Circulation -- Periodicals; Perfusion -- Periodicals; Circulation extracorporelle -- Périodiques; Perfusion -- Périodiques; 617.41
• DOI: 10.1177/0267659114557184
• Languages: English
• ISSNs: 0267-6591

Abstract

Aim: The aim of this study was to ascertain if a score, directly derived from CPB records, could correlate to major postoperative outcomes. Methods: An additive score (QualyP Score) was created from 10 parameters: peak lactate value during CPB, peak VCO2 i, lowest DO2 i/VCO2 i, peak respiratory quotient, CPB time, cross-clamp time, lowest CPB temperature, circulatory arrest, ultrafiltration during CPB, number of packed red cells transfused intraoperatively. The PerfSCORE was calculated, as well. Multivariable logistic regression models were built to detect the independent predictors of: peak lactate >3 mmol/L during the first three postoperative days; the incidence of acute kidney injury network (AKIN) 1-2-3; respiratory insufficiency; mortality. Results: The mean score was 4.8±2.6 (0-10). A QualyP Score ≥1 was predictive of postoperative acidosis (OR=1.595). A score ≥2 was predictive of AKIN 2 (OR=1.268) and respiratory insufficiency (OR=1.526). A score ≥5 was predictive of AKIN 3 (OR=1.848) and mortality (OR=1.497). Conclusions: QualyP Score may help to provide a quality marker of perfusion, emphasizing the need for goal-directed perfusion strategies.