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

• Published in: Perfusion Vol. 30; no. 6; pp. 448 - 456
• Main Authors: Rubino, AS, Torrisi, S, Milazzo, I, Fattouch, K, Busà, R, Mariani, C, D’Aleo, S, Giammona, D, Sferrazzo, C, Mignosa, C
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.09.2015; Sage Publications Ltd
• Subjects: Aged; Biomarkers - blood; Carbon Dioxide - blood; Cardiopulmonary Bypass - adverse effects; Female; Humans; Lactic Acid - blood; Male; Middle Aged; Postoperative Complications - blood; Predictive Value of Tests; Prospective Studies; Retrospective Studies; perfusion; risk score; quality
• ISSN: 0267-6591; 1477-111X
• DOI: 10.1177/0267659114557184

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 VCO2i, lowest DO2i/VCO2i, 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.