Assessment of Risk Prediction Using Edmonton Frail Scale and European System for Cardiac Operative Risk Evaluation II among Older Patients Undergoing Coronary Artery Bypass Graft Surgery in a Tertiary Care Hospital in India
Bibliographic record
Abstract
Abstract Background: The risk assessment for outcomes of older people undergoing cardiac surgery employ scales such as the Euro-Score II, and STS (Society for Thoracic Surgeons), which use clinical and laboratory data. Some studies have suggested a lower accuracy in older patients. Frailty assessment, using functional parameters, has shown promise in this age group. The aim of this study is to compare the validity of risk prediction of Euro-score II, with the Edmonton Frail Scale (EFS), in older patients undergoing elective coronary artery bypass grafting (CABG). Methods: This was a prospective, observational study of a cohort of patients above 60 years scheduled for elective CABG in a single centre. The patients were graded on the Euro-Score II scale and the EFS scales. The primary outcome of 30 th day mortality, and the secondary outcome of immediate post-operative complications during hospitalization were recorded. Results: A total of 487 patients were recruited. The mean age was 68 years. Male subjects comprised 81.1% of the study group. Classification of risk as per the EFS placed 76.3 % as low risk, 23.4% as intermediate, and none were considered to be high risk. The EuroScore II classification placed 86% in the intermediate and high risk groups. The AUC in the ROC (receiver operator curve) for the EFS was 0.793 and for the and EuroScoreII it was 0.752. The 30th day mortality threshold fit occurred at 5/6 score for both EuroScore II and EFS. Euroscore- II sensitivity/specificity was 66.7%/75.1% respectively. The EFS had a sensitivity of 66.7% and a specificity of 77.1%. The ROC curves for the secondary outcomes were not significant. Conclusion: Both scales are of modest value in predicting short-term mortality in older patients, and require further refinements for improving clinical decision-making in the individual patient.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".