Minerva anestesiologica
-
Prognostic models are often used to assess the quality of healthcare. Several scores were developed to predict mortality after cardiac surgery, but none has reached optimal performance in subsequent validations. We validate the most used scores (EUROSCORE I and II, STS, and ACEF) on a cohort of cardiac-surgery patients, assessing their robustness against case-mix changes. ⋯ Cardiac surgery scores calibrate poorly when the case-mix of validation and development samples differs. To grant reliability for benchmarking, they should be validated in the clinical settings on which they are applied and updated periodically. Advanced statistical tools are essential for the correct interpretation and application of severity scores.
-
Minerva anestesiologica · Jul 2020
Observational StudyNeuromuscular monitoring using TOF-Cuff® versus TOF-Scan®: an observational study under clinical anesthesia conditions.
Anesthesia guidelines advise objective neuromuscular monitoring. Acceleromyography, the standard technique used in clinical practice, is commonly used with the train-of-four (TOF) nerve stimulation pattern. Objective of this study was to compare the performance of two devices, TOF-Scan® and TOF-Cuff®. ⋯ TOF-Cuff® consistently recorded the endpoints earlier than TOF-Scan®. Despite large intra-individual variations found with both devices, these results could be meaningful in a clinical setting.