Abstract
Objective: Coronary artery bypass graft (CABG) surgery, while common for treating coronary artery stenosis, faces challenges in accurately predicting postoperative mortality, with the Parsonnet score being a frequently used tool that has yet to be adequately validated in high-mortality populations. This study aimed to evaluate the predictive capability of the Parsonnet score for in-hospital mortality among isolated CABG patients at an Indonesian cardiac centre.
Methods: This cross-sectional study included patients who underwent CABG surgery and received care in the intensive care unit (ICU) at an integrated heart service facility from January 2019 to December 2023. Patients were categorized into survivors and non-survivors based on their in-hospital mortality status following surgery. The Parsonnet score was calculated according to established protocols.
Results: Among 137 patients, the post-CABG mortality rate was 9.5%. Diabetes mellitus emerged as a significant independent risk factor for mortality (adjusted prevalence ratio [APR] 33.086, 95% confidence interval [CI] 3.85-297.16). The median Parsonnet score significantly differed between groups, with non-survivors scoring higher (8.00 [5.00-56.00] vs survivors 5.00 [0.00-61.00], p=0.002). The area under the curve (AUC) was determined to be 0.763 (95% CI 0.674-0.853, p=0.002), indicating good predictive performance. The optimal cut-off value was 5.50, achieving a sensitivity of 92.30% and a specificity of 37.10%. The Parsonnet score demonstrated moderate predictive value for mortality, particularly for scores exceeding 10 (p=0.006).
Conclusion: In a population with a higher-than-average rate of post-CABG mortality, the Parsonnet score demonstrated solid predictive value and moderate calibration for mortality risk.
Muhammad Afdhal Ruslan, Hisbullah Hisbullah, Andi Adil, Syafri Kamsul Arif, Faisal Faisal, Muhammad Rum
