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Scoring Systems Estimating Length of Stay in Intensive Care Unit Before Coronary Artery Bypass Grafting

Fatih AksoyI

DOI: 10.21470/1678-9741-2021-0131

We interestingly read the article by Zarrizi et al.[1] entitled “Predictors of Length of Stay in Intensive Care Unit after Coronary Artery Bypass Grafting”. First, I congratulate the authors for their invaluable contribution to the literature. On the other hand, I would like to point out some information about the scores and preoperative estimating in intensive care stay.

The authors in that article developed a scoring system including number of chest tubes, development of atrial fibrillation, and atelectasis. Accordingly, they showed that this scoring system was useful in predicting the length of stay in intensive care unit after coronary artery bypass grafting. Although the results of this study were useful for clinical practice, they do not provide additional information on the duration of intensive care unit length of stay before coronary artery bypass grafting. In a previous article, we showed that the CHA2DS2-VASc - congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke or transient ischemic attack, vascular disease, age 65 to 74 years, sex category - score correlates with coronary care unit length of stay and new-onset atrial fibrillation in patients with ST elevation myocardial infarction[2]. Additionally, we showed that the CHA2DS2-VASc and anticoagulation and risk factors in atrial fibrillation (ATRIA) scores were useful in detecting postoperative atrial fibrillation after coronary artery bypass grafting and that these scores are related to intensive care unit length of stay[3]. I believe that it would be useful if the authors provided data about these easy scoring systems on intensive care unit length of stay.

The CHA2DS2-VASc and ATRIA risk scores are cheap and easy scoring systems that are used to predict the risk of thromboembolism in non-valvular atrial fibrillation patients[4,5]. It has been showed that these scores predicted several anatomical and clinical diseases in cardiovascular practice[6-9]. Because of that, these scoring systems may be used to assess risk and estimate length of stay in intensive care in patients undergoing coronary artery bypass grafting.


1. Zarrizi M, Paryad E, Khanghah AG, Leili EK, Faghani H. Predictors oflength of stay in intensive care unit after coronary artery bypass grafting:development a risk scoring system. Braz J Cardiovasc Surg. 2021;36(1):57-63.doi:10.21470/1678-9741-2019-0405. [MedLine]

2. Aksoy F, Baş HA, Bağcı A, Oskay T. The CHA2DS2-VASc score forpredicting atrial fibrillation in patients presenting with ST elevationmyocardial infarction: prospective observational study. Sao Paulo Med J.2019;137(3):248-54. doi:10.1590/1516-3180.2018.0431140319. [MedLine]

3. Uysal D, Aksoy F, Ibrişim E. The validation of the ATRIA andCHA2DS2-Vasc scores in predicting atrial fibrillation after coronary arterybypass surgery. Braz J Cardiovasc Surg. 2020;35(5):619-25. [MedLine]

4. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, etal. 2016 ESC guidelines for the management of atrial fibrillation developed incollaboration with EACTS. Eur J Cardiothorac Surg. 2016;50(5):e1-e88.doi:10.1093/ejcts/ezw313. [MedLine]

5. Singer DE, Chang Y, Borowsky LH, Fang MC, Pomernacki NK, Udaltsova N, et al. A new risk scheme to predict ischemic stroke and other thromboembolism in atrial fibrillation: the ATRIA study stroke risk score. J Am Heart Assoc. 2013;2(3):e000250. doi:10.1161/JAHA.113.000250.

6. Aksoy F, Guler S, Kahraman F, Oskay T, Varol E. The relation between echocardiographic epicardial fat thickness and CHA2DS2-VASc score in patients with sinus rhythm. Braz J Cardiovasc Surg. 2019;34(1):41-7. doi:10.21470/1678-9741-2018-0230.

7. Aksoy F, IŞIK İB, BAŞ HA, BAĞCI A, Kahraman F, Okudan YE, et al. Usefulness of the cha2ds2-vasc score to predict “st segment resolution failure” in patients treated with primary percutaneous coronary intervention for st-segment elevation myocardial infarction. Dicle Tıp Dergisi. 2019;46:847-855.

8. Aksoy F, Guler S, Kahraman F, Kuyumcu MS, Bagcı A, Bas HA, et al. The relationship between mitral annular calcification, metabolic syndrome and thromboembolic risk. Braz J Cardiovasc Surg. 2019;34(5):535-41. doi:10.21470/1678-9741-2019-0062.

9. Aksoy F, Bagcı A. Predictive value of ATRIA risk score for contrastinduced nephropathy after percutaneous coronary intervention for ST-segment elevation myocardial infarction. Rev Assoc Med Bras (1992). 2019;65(11):1384-90. doi:10.1590/1806-9282.65.11.1384.

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