Year : 2013  |  Volume : 16  |  Issue : 4  |  Page : 300--301

Authors' reply


Deepak Borde1, Uday Gandhe1, Neha Hargave1, Kaushal Pandey2, Vishal Khullar2,  
1 Department of Cardiac Anesthesia, P.D. Hinduja National Hospital, Lilavati Hospital, Fortis Hospital, Mumbai, Maharashtra, India
2 Department of Cardiac Surgery, P.D. Hinduja National Hospital, Lilavati Hospital, Fortis Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Deepak Borde
Department of Cardiac Anesthesia, P.D. Hinduja National Hospital, Veer Savarkar Marg, Mahim, Mumbai, Maharashtra
India




How to cite this article:
Borde D, Gandhe U, Hargave N, Pandey K, Khullar V. Authors' reply.Ann Card Anaesth 2013;16:300-301


How to cite this URL:
Borde D, Gandhe U, Hargave N, Pandey K, Khullar V. Authors' reply. Ann Card Anaesth [serial online] 2013 [cited 2021 Aug 2 ];16:300-301
Available from: https://www.annals.in/text.asp?2013/16/4/300/119187


Full Text

The Editor,

We thank the authors [1] for showing interest in our recently published article [2] and supporting the proposal of forming a national database and risk stratification tools to provide better quality health-care to cardiac surgical patients in India. Our intention was to evaluate the applicability of the scoring systems: European system of cardiac operative risk evaluation II and Society of Thoracic Surgeons risk-score for risk stratification in Indian patients undergoing cardiac surgery in various risk categories and not to compare it with previously published studies. We do agree with the authors about variation in the study cohorts. Over estimation of mortality in high-risk patients in our study could be the initial trend as only 8% patients belonged to high-risk group in our study. We are planning for a larger multi-center study with significantly more subjects then only we would draw final conclusions.

Although, patient population included in our study does not reflect pan Indian patient population, it's only by gathering data from various Indian cardiac centers we will be able to comment on outcome trends in Indian cardiac surgical practice. Malik and Chauhan's claim that India is one of the leading countries in terms of the number of off pump coronary artery bypass graft (CABG) surgeries is not supported by any published data. There is tremendous variation in practices across India in performing CABG surgeries and various teams have modified their strategies according to changing evidence. In this regard, significance of forming a national database has been aptly emphasized in the editorial by Neema [3] and in the invited commentary by Varma. [4]

We do not agree with the authors that forming a national database is a distant dream. If European Association of Cardio-Thoracic Surgery [5] can form a database involving 29 countries with 366 hospitals with more than 10 lac patients records with wide variation in patient care, then surely, we can also do it; it needs motivation, positive thinking and realization that data base, its analysis and generation of knowledge is the time-tested and right way to move forward.

References

1Malik M, Chauhan S. The application of European system for cardiac operative risk evaluation II and Society of Thoracic Surgeons risk score for risk stratification in Indian patients undergoing cardiac surgery. Ann Card Anaesth 2013;16:299-300.
2Borde D, Gandhe U, Hargave N, Pandey K, Khullar V. The application of European system for cardiac operative risk evaluation II (EuroSCORE II) and society of thoracic surgeons (STS) risk-score for risk stratification in Indian patients undergoing cardiac surgery. Ann Card Anaesth 2013;16:163-6.
3Neema PK. The value of database and data interpretation. Ann Card Anaesth 2013;16:161-2.
4Varma PK. A small step in right direction. Ann Card Anaesth 2013;16:167-8.
5Head SJ, Howell NJ, Osnabrugge RL, Bridgewater B, Keogh BE, Kinsman R, et al. The European Association for Cardio-Thoracic Surgery (EACTS) database: an introduction. Eur J Cardiothorac Surg 2013;44:e175-80.