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- W2078111514 abstract "Nishida et al. need to be congratulated for achieving an overall mortality rate of 7.2% in 461 patients undergoing aortic surgery [1]; however, their manuscript raises a number of issues.Mortality prediction models are classically assessed via receiver operating curve (ROC) and Hosmer-Lemeshow statistic assessment [2,3]. The use of a 20-year study period is probably too long, due to improvements in surgical, anaesthetic and medical care, hence the recalibration of EuroSCORE to create EuroSCORE II. With such a long study period the chronobiology of aortic dissection may be an important issue [4,5].We agree with their interpretation that a ROC of nearly 0.8 is impressive for the EuroSCORE II risk model in aortic surgery in their patient group; however their demonstration that in high risk patients none of the models are accurate means clinical usage is limited. Unfortunately no Hosmer-Lemeshow statistic was presented. Failure to achieve an adequate ROC and Hosmer-Lemeshow statistic means adoption can not be recommended.The operation types for this study seem skewed, as 220 patients underwent isolated arch surgery, and only 7 patients underwent root and arch surgery. In addition no mention of redo numbers were made in the manuscript.Risk modelling for CABG or valve surgery requires 10,000 to 20,000 patients per procedure to be operated on in the modern era to avoid being underpowered. As aortic surgery can be simplistically divided into root, arch and descending aorta surgery, risk modelling for aortic surgery is probably beyond any single institution due to number restrictions. An international collaborative project is needed.Conflict of interest: none declared" @default.
- W2078111514 created "2016-06-24" @default.
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- W2078111514 date "2014-03-17" @default.
- W2078111514 modified "2023-09-27" @default.
- W2078111514 title "eComment. EuroSCORE II and prediction of in-hospital mortality of thoracic aortic surgery" @default.
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- W2078111514 doi "https://doi.org/10.1093/icvts/ivu029" @default.
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