Open Access

Erratum to: Development of the Post Cardiac Surgery (POCAS) prognostic score

  • Eduardo Tamayo1,
  • Inma Fierro2,
  • Juan Bustamante-Munguira3Email author,
  • María Heredia-Rodríguez1,
  • Pablo Jorge-Monjas1,
  • Laura Maroto4,
  • Esther Gómez-Sánchez1,
  • Francisco Jesús Bermejo-Martín5,
  • Francisco Javier Álvarez2 and
  • José Ignacio Gómez-Herreras1
Critical Care201519:395

https://doi.org/10.1186/s13054-015-1117-0

Received: 12 October 2015

Accepted: 27 October 2015

Published: 9 November 2015

The original article was published in Critical Care 2013 17:R209

After Publication of the original article [1] it has been brought to our attention that none of the tables referred to in the text have been included in the article. Tables 1, 2, 3, 4, 5, 6 and 7 are now displayed below.
Table 1

Patient population profile (Survivors and non-survivors)

Variable

Survivors (N = 829)

Non survivors (N = 80)

P value

Preoperative factors

 Age, years

66.3 ± 11.2

68.9 ± 11.3

0.05

 Sex, M/F male gender

574 (69.2)

48 (60)

0.09

 Peso, kg

72.7 ± 15

71.9 ± 11.4

0.69

 Talla, cm

163.3 ± 9

162.3 ± 8.9

0.34

 Hypertension

449 (54.2)

50 (62.5)

0.15

 Atrial fibrillation

167 (20.1)

23 (28.8)

0.07

 Diabetes mellitus

198 (23.9)

20 (25)

0.82

 Obesity

132 (15.9)

12 (15)

0.82

 Smoking

114 (13.8)

6 (7.5)

0.11

 Drinking alcohol

50 (6)

2 (2.5)

0.19

 Hepatic disease

23 (2.8)

3 (3.8)

0.61

 Respiratory disease

93 (11.2)

15(18.8)

0.04

 Chronic renal failure

50 (6)

11 (13.8)

0.008

 Immunosuppression

23 (2.8)

4 (5.0)

0.26

 Previous cardiac surgery

79 (9.5)

11 (13.8)

0.61

 Emergent surgery

70 (8.4)

23 (28.8)

0.0001

Perioperative factors

 Left ventricle ejection fraction

56.8 ± 11.5

49.6 ± 13.6

0.0001

 Valve

455 (54.9)

47 (58.8)

0.5

 CABG

399 (48.1)

39 (48.8)

0.91

 Valve + CABG

109 (13.1)

20 (25.0)

0.004

 Total CPB time. min

105.3 ± 44.29

156.1 ± 77.7

0.0001

 Aortic cross-clamp time, min

77.3 ± 37.04

106.9 ± 56.7

0.0001

Postoperative value

 Duration of mechanical ventilation, days

25.23 ± 62.59

19.75 ± 31.43

0.81

 Reintubation

25 (3)

16 (20)

0.0001

 Politrasfusion

254 (30.6)

25 (31.3)

0.640

 Acute renal failure

67 (8.1)

36 (45.0)

0.0001

 Reintervención

21 (2.5)

13 (16.3)

0.0001

 Intra-aortic balloon pump

32 (3.9)

27 (33.8)

0.0001

 Pneumonia

35 (4.2)

15 (18.8)

0.0001

 Surgical site infections

25 (3)

1 (1.3)

0.36

 Preoperative hospitalization, days

18.2 ± 15.5

10.6 ± 11.3

0.0001

 Mean ICU stay, days

4.7 ± 12.1

14.3 ± 20.9

0.0001

 Duration of hospitalization after surgery, days

22.8 ± 20.9

24.9 ± 23.7

0.43

Risk score

 Additive EuroSCORE, points

4.5 ± 2.8

7.4 ± 4.5

0.0001

 Logistic EuroSCORE, points

5.4 ± 6.2

16.7 ± 18.5

0.0001

 ACEF score, points

1.2 ± 0.4

1.7 ± 0.6

0.0001

 SOFA score, points

5.5 ± 1.7

7.7 ± 1.7

0.0001

 SAP II score, points

28.9 ± 8.7

43.0 ± 11.6

0.0001

 APACHE II score, points

13.3 ± 3.8

18.3 ± 5.6

0.0001

Values are expressed as numbers (n), percentages (%), and means ± SD

APACHE II Acute Physiology and Chronic Health Evaluation II, CABG coronary artery bypass graft, CPB cardiopulmonary bypass

Table 2

Parameters at the admission to the intensive care unit in survivors and non-survivors

Variable

Survivors (n = 829)

Non-survivors (n = 80)

p value

pH

7.37 ± 0.06

7.31 ± 0.9

0.0001

HCO3 mEq/l

24.4 ± 3.15

21.04 ± 3.9

0.0001

PCO2, mmHg

41.0 ± 6.3

41.3 ± 6.2

0.69

PaO2/FiO2, range

245.6 ± 72.8

226.2 ± 77.1

0.024

Core temperature, °C

36.6 ± 0.8

36.7 ± 1.5

0.22

Leukocyte count, cells/mm3

10535.1 ± 6396.8

13454.8 ± 5727.4

0.0001

C-reactive protein, mg/L

14.3 ± 35.1

29.5 ± 53.1

0.014

Procalcitonin, ng/mL

0.8 ± 4.9

3.1 ± 5.

0.0001

Lactates, mmol/L

29.4 ± 14.9

63.6 ± 43.7

0.0001

ScvO2, %

73.4 ± 8.6

65.6 ± 12.3

0.0001

Heart rate, beats/min

92.3 ± 18.5

109.7 ± 17.2

0.0001

Mean arterial pressure, mmHg

72.5 ± 13.7

53.6 ± 10.5

0.0001

Glucose, mg/dl

181 ± 57.2

193.7 ± 70.5

0.13

Creatinine, mg/dl

1 ± 0.5

1.5 ± 1.3

0.001

Hematocrit, %

29.1 ± 4.4

28 ± 4.5

0.04

Na, mmol/L

140.1 ± 7.6

142 ± 4.8

0.028

K, mmol/L

3.9 ± 0.6

4 ± 0.7

0.47

TnT, μg/l

0.8 ± 1.4

3.8 ± 6.1

0.0001

CK-MB, ng/mL

336.4 ± 283.2

161.6 ± 186.4

0.0001

INR, range

1.5 ± 0.2

2 ± 0.8

0.0001

aPTTr, range

1.2 ± 0.3

1.8 ± 1.2

0.0001

Platelet count, cells/mm3

119490.8 ± 47226.4

119898.7 ± 65476.3

0.95

Values are expressed as means ± SD

aPTTr activated partial thromboplastin time ratio, CK-MB creatine kinase-MB, INR international normalized ratio, K potassium, Na sodium, PaO2/FiO2 ratio ratio of partial pressure of arterial oxygen to fraction of inspired oxygen, PCO 2 partial pressure of carbon dioxide, ScvO2 central venous oxygen saturation, TnT troponin T

Table 3

Logistic regression model: risk factors for 90-day In-Hospital Mortality

 

B

SE

p value

OR

95 % CI

Constant

−11.561

1.155

0.0001

0.0001

 

1000/MAP (mmHg)

0.308

0.046

0.0001

1.360

1.242–1.489

1000/Bicarbonate (mEq/L)

0.034

0.013

0.011

1.035

1.008–1.062

Lactate (mg/dL)

0.022

0.007

0.001

1.023

1.009–1.036

INR

1.025

0.397

0.0101

2.788

1.282–6.064

Hosmer-Lemeshow X 2 = 8.62; P = .37. Multicollinearity diagnostics: 1000/MAP, 0.78 tolerance; 1000/Bicarbonate, 0.87 tolerance; Lactate, 0.64 tolerance and INR, 0.65 tolerance

B regression coefficient, CI confidence interval, INR international normalized ratio, MAP Mean arterial pressure, OR Odds Ratio

Table 4

A new system to predict operative mortality in patients undergoing cardiac surgery: POCAS score

Lactate (mmol/L)

Score

INR

Score

 <16.00

3

<1.31

12

 16.00 to 24.90

4

1.31 to 1.52

14

 25.00 to 34.90

6

1.53 to 1.94

16

 35.00 to 52.90

9

1.95 to 2.65

20

 53.00 to 79.00

14

>2.65

30

 >79.00

21

  

MAP (mm Hg)

Score

Bicarbonate (mEq/L)

Score

 >75

35

>27.4

14

 69 to 75

41

25.7 to 27.4

15

 61 to 68

46

24.1 to 25.6

16

 60

50

22.8 to 24.0

17

 45 to 59

58

20.4 to 22.7

18

 <45

75

14.6 to 20.3

22

  

<14.6

35

Table 5

Development series: predictive function of POCAS score scale for 90-day In- Hospital Mortality (Logistic regression)

 

B

SE

p value

OR

95 % CI

POCAS

0.113

0.011

0.0001

1.119

1.096

1.143

Constant

−12.671

1.051

0.0001

0.000

  

B regression coefficient, CI confidence interval, OR Odds Ratio

Table 6

Operative risk categories with corresponding cumulative risk score for 90-day In-Hospital Mortality after cardiac surgery for the risk groups calculated from the roc curve, cumulative risk score*

Risk score

Observed no.

Predicted no.

% probability (95 % CI)

90-Day In-Hospital Mortality (%)

Operative risk categories

% probability (95 % CI)

<75

1

1

0.92 (0.89–0.95)

0.4

Low

2.33 (2.19–2.46)

75–81

3

3

2.10 (2.03–2.16)

1.5

82–90

11

11

4.82 (4.62–5.02)

6.1

91–100

12

12

12.99 (12.34–13.65)

11.1

Medium

16.32 (15.25–17.38)

101–105

11

10

25.53 (24.40–26.66)

28.2

106–128

29

28

56.22 (51.86–60.58)

55.8

High

56.22 (51.86–60.58)

>128

13

13

94.98 (92.75–97.21)

100.0

Very high

94.98 (92.75–97.21)

CI confidence interval, n number

Table 7

Validity of Additive EuroSCORE, Logistic EuroSCORE, ACEF, SOFA, SAP II, APACHE II, and POCAS to predict the 90-day In-Hospital Mortality rate after cardiac surgery with CEC

Criterion for assigning a mortality

AUC [95 % IC]

Ind.Youden Máx

Cutoff value

Sensitivity

Specifity

NPV

PPV

Χ 2 test AUCs (other scale*POCAS)

POCAS

0.899 [0.864–0.934]*

0.63

85.5

0.91

0.72

98.7

24.9

--

APACHE II

0.768 [0.709–0.828]*

0.42

17.5

0.54

0.88

95.2

30.7

20.42*

SOFA

0.825 [0.782–0.867]*

0.52

5.5

0.92

0.59

98.7

18.8

10.16**

SAPS II

0.847 [0.800–0.893]*

0.56

32.5

0.85

0.71

98.2

20.1

24.10*

ACEF

0.699 [0.639–0.758]*

0.31

1.49

0.50

0.81

93.5

22.3

652.30*

Logistic EuroSCORE

0.754 [0.693–0.814]*

0.40

4.11

0.81

0.58

96.7

17.3

398.28*

Additive EuroSCORE

0.714 [0.647–0.780]*

0.38

5.50

0.71

0.67

95.4

19.2

30.39*

(*) p < 0.0001; (**) p < 0.05

AUC area under the curve, NPV negative predictive value, PPV positive predictive value, SOFA Secuencial Organ Failure Assesment, SAP II Simplified Acute Physiology Score II, APACHE II Acute Physiology and Chronic Health Evaluation II

Notes

Declarations

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors’ Affiliations

(1)
Department of Anaesthesiology and Reanimation, Hospital Clinico Universitario de Valladolid
(2)
Department of Pharmacology and Therapeutics, Facultad de Medicine, University of Valladolid
(3)
Department of Cardiovascular Surgery, Hospital Universitario de La Princesa
(4)
Department of Cardiac Surgery, Hospital Clinico Universitario de Valladolid
(5)
Infection & Immunity Unit, Hospital Clínico Universitario de Valladolid, SACYL/IECSCYL

Reference

  1. Tamayo E, Fierro I, Bustamante-Munguira J, Heredia-Rodríguez M, Jorge-Monjas P, Maroto L, et al. Development of the Post Cardiac Surgery (POCAS) prognostic score. Crit Care. 2013;17:R209.PubMed CentralView ArticlePubMedGoogle Scholar

Copyright

© Tamayo et al. 2015

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