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Ann Thorac Surg 2004;78:1534-1535
© 2004 The Society of Thoracic Surgeons

INVITED COMMENTARY

Victor A. Ferraris, MD, PhD

Division of Cardiothoracic and Vascular Surgery, University of Kentucky, C208, UKMC800 Rose St, Lexington, KY 40536, USA

ferraris@earthlink.net

The first 20% of the full text of this article appears below.

The article by Nilsson and coworkers claims that the EuroSCORE (a popular mortality risk scoring system used extensively in Europe) is also useful for predicting resource utilization in cardiac surgical patients. This work deserves comment in three areas.

First, there are some quirks about the authors' measurements that need to be pointed out. The authors use log transformation of the dependent variable (hospital cost) in order to measure the relationship of EuroSCORE to hospital costs. Their Figure 2 shows a very linear regression between cost and EuroSCORE, only after the cost data are log transformed. The advantage of log transformation is that the influence of outliers is minimized and the regression coefficient looks better. The disadvantage is that the resulting regression line using log transformed data are always more linear than nonlog transformed data and gives an inflated sense of dependence of the outcome variable (cost) on the predictor variable (EuroSCORE). It would be wishful thinking to suppose that the EuroSCORE predicts hospital cost without significant variability. In fact, the authors . . . [Full Text of this Article]






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