• Priyadharshanan Ariyaratnam, Mahmoud Loubani, James Biddulph, Julie Moore, Neil Richards, Mubarak Chaudhry, Vincent Hong, Mark Haworth, and Anantha Ananthasayanam.
• Department of Cardiothoracic Surgery. Electronic address: priyadariyaratnam@yahoo.co.uk.
• J. Cardiothorac. Vasc. Anesth. 2015 Jan 1; 29 (3): 565-9.

ObjectiveThe Intensive Care National Audit and Research Centre (ICNARC) scoring system was conceived in 2007, utilizing 12 physiologic variables taken from the first 24 hours of adult admissions to the general intensive care unit (ICU) to predict in-hospital mortality. The authors aimed to evaluate the ICNARC score in predicting mortality in cardiac surgical patients compared to established cardiac risk models such as logistic EuroSCORE as well as to the Acute Physiology and Chronic Health Evaluation (APACHE) II.DesignRetrospective analysis of data collected prospectively.SettingSingle-center study in a cardiac intensive care in a regional cardiothoracic center.ParticipantsPatients undergoing cardiac surgery between January 2010 and June 2012.MethodsA total of 1,646 patients were scored preoperatively using the logistic EuroSCORE and postoperatively using ICNARC and APACHE II. Data for comparison of scoring systems are presented as area under the receiver operating characteristic curve.Measurements And Main ResultsThe mean age at surgery was 67 years±10.1. The mortality from all cardiac surgery was 3.2%. The mean logistic EuroSCORE was 7.31±10.13, the mean ICNARC score was 13.42±5.055, while the mean APACHE II score was 6.32±7.731. The c-indices for logistic EuroSCORE, ICNARC, and APACHE II were 0.801, 0.847 and 0.648, respectively.ConclusionThe authors have, for the first time, validated the ICNARC score as a useful predictor of postoperative mortality in adult cardiac surgical patients. This could have implications for postoperative management, focusing the utilization of resources as well as a method to measure and compare performance in the cardiothoracic ICU.Copyright © 2015 Elsevier Inc. All rights reserved.

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