External validation of the REMEMBER score
BackgroundThe use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) after coronary artery bypass grafting (CABG) is associated with high in-hospital mortality rates. The pRedicting mortality in patients undergoing venoarterial Extracorporeal MEMBrane oxygenation after coronary artEry byp...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1192300/full |
| _version_ | 1797770389476081664 |
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| author | Armin Darius Peivandi Henryk Welp Sebastian Kintrup Nana Maria Wagner Angelo Maria Dell’Aquila |
| author_facet | Armin Darius Peivandi Henryk Welp Sebastian Kintrup Nana Maria Wagner Angelo Maria Dell’Aquila |
| author_sort | Armin Darius Peivandi |
| collection | DOAJ |
| description | BackgroundThe use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) after coronary artery bypass grafting (CABG) is associated with high in-hospital mortality rates. The pRedicting mortality in patients undergoing venoarterial Extracorporeal MEMBrane oxygenation after coronary artEry bypass gRafting (REMEMBER) score has been created to predict in-hospital mortality in this subgroup of patients. The aim of this study is to externally validate the REMEMBER score.MethodsAll CABG patients who received VA-ECMO during or after the operation at our center between 01/2012 and 12/2021 were included in the analysis. Discrimination was assessed using concordance statistics, visualized by ROC curve analysis. Calibration-in-the-large and Calibration slope were tested separately.ResultsA total of 107 patients (male: n = 78, 72.9%) were included in this study. The in-hospital mortality rate in our cohort was 45.8% compared with 55% in the original study. The REMEMBER score median predicted mortality rate was 52% (76.9–36%). However, the REMEMBER score showed low discriminative ability [AUC: 0.623 (p = 0.0244; 95% CI = 0.524–0.715)] and inaccurate calibration (intercept = 0.25074; p = 0.0195; slope = 0.39504; p = 0.0303), indicating poor performance.ConclusionsThe REMEMBER score did not predict in-hospital mortality and was therefore not applicable in our cohort of patients. Additional external validation studies in a multicenter setting are therefore advisable. |
| first_indexed | 2024-03-12T21:21:42Z |
| format | Article |
| id | doaj.art-554e9aacc3be431fb9c7cff523c533a9 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-12T21:21:42Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-554e9aacc3be431fb9c7cff523c533a92023-07-28T15:13:06ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-07-011010.3389/fcvm.2023.11923001192300External validation of the REMEMBER scoreArmin Darius Peivandi0Henryk Welp1Sebastian Kintrup2Nana Maria Wagner3Angelo Maria Dell’Aquila4Department of Cardiothoracic Surgery, University Hospital Muenster, Muenster, GermanyDepartment of Cardiothoracic Surgery, University Hospital Muenster, Muenster, GermanyDepartment of Anesthesiology, Intensive Care and Pain Therapy, University Hospital Muenster, Muenster, GermanyDepartment of Anesthesiology, Intensive Care and Pain Therapy, University Hospital Muenster, Muenster, GermanyDepartment of Cardiothoracic Surgery, University Hospital Muenster, Muenster, GermanyBackgroundThe use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) after coronary artery bypass grafting (CABG) is associated with high in-hospital mortality rates. The pRedicting mortality in patients undergoing venoarterial Extracorporeal MEMBrane oxygenation after coronary artEry bypass gRafting (REMEMBER) score has been created to predict in-hospital mortality in this subgroup of patients. The aim of this study is to externally validate the REMEMBER score.MethodsAll CABG patients who received VA-ECMO during or after the operation at our center between 01/2012 and 12/2021 were included in the analysis. Discrimination was assessed using concordance statistics, visualized by ROC curve analysis. Calibration-in-the-large and Calibration slope were tested separately.ResultsA total of 107 patients (male: n = 78, 72.9%) were included in this study. The in-hospital mortality rate in our cohort was 45.8% compared with 55% in the original study. The REMEMBER score median predicted mortality rate was 52% (76.9–36%). However, the REMEMBER score showed low discriminative ability [AUC: 0.623 (p = 0.0244; 95% CI = 0.524–0.715)] and inaccurate calibration (intercept = 0.25074; p = 0.0195; slope = 0.39504; p = 0.0303), indicating poor performance.ConclusionsThe REMEMBER score did not predict in-hospital mortality and was therefore not applicable in our cohort of patients. Additional external validation studies in a multicenter setting are therefore advisable.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1192300/fullextracorporeal life supportcoronary artery bypass graftingscore systemcardiac failurerisk score |
| spellingShingle | Armin Darius Peivandi Henryk Welp Sebastian Kintrup Nana Maria Wagner Angelo Maria Dell’Aquila External validation of the REMEMBER score Frontiers in Cardiovascular Medicine extracorporeal life support coronary artery bypass grafting score system cardiac failure risk score |
| title | External validation of the REMEMBER score |
| title_full | External validation of the REMEMBER score |
| title_fullStr | External validation of the REMEMBER score |
| title_full_unstemmed | External validation of the REMEMBER score |
| title_short | External validation of the REMEMBER score |
| title_sort | external validation of the remember score |
| topic | extracorporeal life support coronary artery bypass grafting score system cardiac failure risk score |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1192300/full |
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