Cardiac surgery risk stratification scores correlate poorly with costs

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1. The six most commonly used preoperative scoring systems had weak linear correlations with hospital costs. 

2. Hospital costs were correlated with length of ICU stay, which was not well predicted by preoperative scoring systems. 

Evidence Rating Level: 2 (Good) 

Study Rundown: A bottom-up method of cost calculations for 887 adult cardiac surgery patients found total hospital expenses to have a weak linear correlation with risk stratification scores, despite statistically significant p values. Since these instruments were designed to predict mortality, the low correlation coefficients may reflect poor prediction of morbidity and ICU stay, which are the main drivers of higher costs. However, the low coefficients may also result from a non-linear predictive relationship between the risk scores and costs.

Click to read the study in The Journal of Cardiothoracic Surgery

Relevant Reading:  EuroSCORE predicts intensive care unit stay and costs of open heart surgery

In-Depth [prospective/randomized etc. study]: This prospective study classified 887 adult cardiac surgery patients at the University of Cologne using six preoperative scoring models. Total hospital costs were calculated for each patient and compared against all six models using Spearman’s and Pearson’s correlation coefficients. The correlation between total hospital costs and calculated risks were low, ranging from Spearman coefficients of 0.122-0.372 and Pearson coefficients of 0.122-0.264.

By Gina Siddiqui and Allen Ho

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