Some CBC parameters have been implicated in individual susceptibility to death, both in heart disease and cardiac surgery populations. The cellular elements of blood are widely affected during cardiopulmonary bypass (CPB), technique used in cardiac surgery. A Complete Blood Count called Risk Score (CBC-RS) was calculated from the average of the deviations of the various elements of the CBC and has been previously validated and published. The CBC-RS showed as excellent predictor of death from all causes in large healthy and cardiovascular risk populations. Despite the effect of CPB on the blood cells, there is no acknowledgement from the prior assessment of this score in the surgical setting. The aim of this study was to evaluate the role of CBC-RS in the surgical risk prediction (mortality and morbidity) in patients undergoing cardiac surgery with CPB. For this, it was evaluated a historical cohort of 428 patients undergoing cardiac surgery with CPB. The individual CBC-RS was calculated using the collected blood count of patients preoperatively. Logistic regression and statistical C analyzed the predictive accuracy of this score. The primary endpoint was in-hospital mortality (all-cause) and secondary outcomes included the majors and bleeding complications. In our study, CBC-RS was a predictor of hospital mortality (OR = 1.28 for each score increments, 95% CI = 1123-1458, p <0.001) and secondary outcomes (OR = 1.208, 95% CI = 1.103 to 1.323, p <0.001). The areas under the curve (AUC) was 0.697 (p <0.001) and 0.636 (p <0.001) for both the primary and secondary endpoints, respectively. In multivariate analysis, after adjustment for other risk predictors (EuroSCORE II and CPB time), the CBC-RS remained significant and was the strongest predictor of mortality. Therefore, the CBC-RS proved to be an independent predictor of mortality and surgical complications during hospitalization. It may be a useful tool in risk assessment of patients undergoing cardiac surgery. / Dentre os diversos parâmetros fornecidos pelo hemograma, alguns já foram implicados em aumento da suscetibilidade individual à morte, tanto em pacientes com patologias cardíacas quanto os submetidos à cirurgia cardíaca. Os elementos celulares do sangue são amplamente afetados durante a circulação extracorpórea (CEC), técnica usada nas cirurgias cardíacas. Um escore calculado a partir dos desvios da média dos diversos componentes do hemograma foi previamente validado, publicado e chamado de Complete Blood Count Risk Score (CBC-RS). O CBC-RS se mostrou excelente preditor de morte por todas as causas em grandes populações saudáveis ou com fatores de risco cardiovascular. Apesar do efeito da CEC sobre as células sanguíneas, não se tem conhecimento da avaliação prévia deste escore no contexto cirúrgico. O objetivo do presente trabalho foi avaliar o papel do CBC-RS na predição de risco cirúrgico (mortalidade e morbidade hospitalar) em pacientes submetidos à cirurgia cardíaca com CEC. Para isso, uma coorte histórica de 428 pacientes submetidos à cirurgia cardíaca com CEC foi avaliada. O CBC-RS individual foi calculado utilizando o hemograma coletado dos pacientes no pré-operatório. A acurácia preditora deste escore foi analisada através regressão logística e estatística C. O desfecho primário avaliado foi a mortalidade hospitalar (por todas as causas) e os desfechos secundários incluíram as complicações maiores e sangramento. Em nosso estudo, o CBC-RS foi um preditor de mortalidade hospitalar (OR = 1,28 por cada aumento de pontuação do CBC-RS, IC 95% = 1.123 - 1.458, p <0,001) e dos desfechos secundários (OR = 1,208, IC 95% = 1,103 - 1,323, p <0,001). As áreas sob a curva (AUC) foram 0,697 (p <0,001) e 0,636 (p <0,001) para os desfechos primário e secundário, respectivamente. Na análise multivariada, após ajuste para preditores de risco pré-operatório (EuroSCORE II) e transoperatório (tempo de CEC) conhecidos, o CBC-RS permaneceu significativo e foi o preditor de mortalidade mais forte. Sendo assim, o CBC-RS se mostrou um preditor independente da mortalidade e complicações cirúrgicas no período hospitalar, podendo representar uma ferramenta útil na avaliação de risco de pacientes submetidos à cirurgia cardíaca.

The thesis aims to describe risk management in the construction company. The work is divided into theoretical and practical part. The theoretical part presenst the classification of risks, describes the various stages of this complex process, including methods and techniques. The practical part is solved on a particular project, it summarises and completes the whole issue of risk.

Management projektů a jejich rizik je v současnosti rozvíjející se disciplína, která si získává stále větší pozornost a uplatnění v praxi. Tato práce popisuje úvod do problematiky řízení rizik, zkoumání metod jejich identifikace, vyhodnocení a managementu, předcházení jejich následkům a jejich zvládání. V další části práce byla provedena analýza vzorků rizik z reálných projektů, byly popsány metody pro identifikaci a vyhodnocení následků rizik v úvodních fázích softwarového projektu, taktéž byly popsány atributy rizik a navržen způsob jejich dokumentace. V závěrečné části zadání byl navržen a implementován prototyp modelové aplikace pro podporu managementu rizik softwarových projektů.

This diploma theses deals with the challenges of a project management in a particular construction company that handles projects on daily basis. I focused on the analysis of a particular project in this company, that has been successfully implemented. This analysis served as a starting point for the designing of the changes, as well as a devising a tool that simplifies the set up of the changes into practice. Selected problem was solved by comparing the project management methodology in the project with the project management practices officially proposed in the literature. Tool design was carried out in the environment of Microsoft Excel. I managed to design a tool in which the shortcomings are treated the way that facilitates their implementation into practice, especially by using an easy environment and outputs well-arranged for the user. This tool is therefore mainly used to eliminate the identified shortcomings and thus to facilitate and simplify project management in practice.

The aim of the thesis is to analyse issues of risk management in a construction company, especially in the context of construction contracts implementation. The first part is devoted to applied terminology and interpretation of relevant terms, followed by a classification of risks from different perspectives, including the risks’ possible further sub classification. Furthermore, significant risk resources and construction participants who might be affected by the risks are presented. The third chapter deals with risk management; individual phases of this complex process are described herein, including their correct sequences, as well as a selection of methods and techniques that are standardly used in risk management. The last, fourth chapter summarises the problems of risk management on a practical example, where a construction company implements a construction contract by applying selected risk management methodologies.