• Victorio C Carosella, Jose L Navia, Sharif Al-Ruzzeh, Hugo Grancelli, Walter Rodriguez, Cesar Cardenas, Jorge Bilbao, and Carlos Nojek.
• Instituto de Cardiología, Hospital Español de Buenos Aires, Ciudad Autónoma de Buenos Aires, C1209AQK Buenos Aires, Argentina. drcarosella@yahoo.com
• Interact Cardiovasc Thorac Surg. 2009 Aug 1; 9 (2): 203-8.

AbstractThis study aims to develop the first Latin-American risk model that can be used as a simple, pocket-card graphic score at bedside. The risk model was developed on 2903 patients who underwent cardiac surgery at the Spanish Hospital of Buenos Aires, Argentina, between June 1994 and December 1999. Internal validation was performed on 708 patients between January 2000 and June 2001 at the same center. External validation was performed on 1087 patients between February 2000 and January 2007 at three other centers in Argentina. In the development dataset the area under receiver operating characteristics (ROC) curve was 0.73 and the Hosmer-Lemeshow (HL) test was P=0.88. In the internal validation ROC curve was 0.77. In the external validation ROC curve was 0.81, but imperfect calibration was detected because the observed in-hospital mortality (3.96%) was significantly lower than the development dataset (8.20%) (P<0.0001). Recalibration was done in 2007, showing excellent level of agreement between the observed and predicted mortality rates on all patients (P=0.92). This is the first risk model for cardiac surgery developed in a population of Latin-America with both internal and external validation. A simple graphic pocket-card score allows an easy bedside application with acceptable statistic precision.

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