000			02809na a2200277 4500
999			_c4092 _d4092
003			PC4092
005			20200305131616.0
008			130622s2013 xxx||||| |||| 00| 0 eng d
040			_cH12O
041			_aeng
100			_aPérez de la Sota, Enrique _91248 _eCirugía Cardiovascular
245	0	2	_aA multicentre Spanish study for multivariate prediction of perioperative in-hospital cerebrovascular accident after coronary bypass surgery: the PACK(2) score. _h[artículo]
260			_bInteractive cardiovascular and thoracic surgery, _c2013
300			_a17(2):353-8; discussion 358.
500			_aFormato Vancouver: Hornero F, Martín E, Rodríguez R, Castellà M, Porras C, Romero B et al. Working Group on Arrhythmia Surgery and Cardiac Pacing of the Spanish Society for Cardiovascular and Thoracic Surgery (SECTCV). A multicentre Spanish study for multivariate prediction of perioperative in-hospital cerebrovascular accident after coronary bypass surgery: the PACK2 score. Interact Cardiovasc Thorac Surg. 2013 Aug;17(2):353-8; discussion 358.
501			_aPMID: 23628652
504			_aContiene 8 referencias.
520			_aOBJECTIVES: To develop a multivariate predictive risk score of perioperative in-hospital stroke after coronary artery bypass grafting (CABG) surgery. METHOD: A total of 26 347 patients were enrolled from 21 Spanish hospital databases. Logistic regression analysis was used to predict the risk of perioperative stroke (ictus or transient ischaemic attack). The predictive scale was developed from a training set of data and validated by an independent test set, both selected randomly. The assessment of the accuracy of prediction was related to the area under the ROC curve. The variables considered were: preoperative (age, gender, diabetes mellitus, arterial hypertension, previous stroke, cardiac failure and/or left ventricular ejection fraction <40%, non-elective priority of surgery, extracardiac arteriopathy, chronic kidney failure and/or creatininemia >= 2 mg/dl and atrial fibrillation) and intraoperative (on/off-pump). RESULTS: Global perioperative stroke incidence was 1.38%. Non-elective priority of surgery (priority; OR = 2.32), vascular disease (arteriopathy; OR = 1.37), cardiac failure (cardiac; OR = 3.64) and chronic kidney failure (kidney; OR = 6.78) were found to be independent risk factors for perioperative stroke in uni- and multivariate models in the training set of data; P < 0.0001; AUC = 0.77, 95% CI 0.73-0.82. The PACK(2) stroke CABG score was established with 1 point for each item, except for chronic kidney failure with 2 points (range 0-5 points); AUC = 0.76, 95% CI 0.72-0.80. In patients with PACK(2) score = 2 points, off-pump reduced perioperative stoke incidence by 2.3% when compared with on-pump CABG. CONCLUSIONS: PACK(2) risk scale shows good predictive accuracy in the data analysed and could be useful in clinical practice for decision making and patient selection.
710			_9353 _aServicio de Cirugía Cardiovascular
856			_uhttp://pc-h12o-es.m-hdoct.a17.csinet.es/pdf/pc/4/pc4092.pdf _ySolicitar documento
942			_n0 _2ddc _cART