Key result
EuroSCORE II demonstrated fair discriminatory power (AUC 0.71; 95% CI 0.65-0.77) but underestimated postoperative mortality in Indonesian cardiac surgery patients.
Why the study?
EuroSCORE II was created to predict mortality after cardiac surgery, but required validation in open cardiac surgery patients in Indonesia.
Does the EuroSCORE II accurately predict postoperative mortality in Indonesian open cardiac surgery patients?
Observational (n=767)
Yes
Does the EuroSCORE II accurately predict postoperative mortality in Indonesian open cardiac surgery patients?
EuroSCORE II underestimates postoperative mortality and has only fair discriminatory power in Indonesian cardiac surgery patients, suggesting it may not be suitable for risk prediction in this specific population.
Caution advised applying EuroSCORE II in Indonesian cardiac surgery; leaves open need for local validation or recalibration.
BACKGROUND: In 2011, the European System for Cardiac Operative Risk (EuroSCORE) II was created as an improvement of the additive/logistic EuroSCORE for the prediction of mortality after cardiac surgery. OBJECTIVE: To validate EuroSCORE II in predicting the mortality of open cardiac surgery patients in Indonesia. METHODS: We performed a multi-center retrospective study of cardiac surgery patients from three participating centers (Dr. Sardjito Hospital, Kariadi Hospital, and Abdul Wahab Sjahranie Hospital) between January 1st, 2016, and December 31st, 2020. Discrimination and calibration tests were performed. RESULTS: The observed mortality rate was 9.5% (73 out of 767 patients). The median EuroSCORE II value was 1.13%. The area under the curve for EuroSCORE II was 0.71 (95% CI: 0.65-0.77), suggesting fair discriminatory power. Calibration analysis suggested that EuroSCORE II underestimated postoperative mortality. Gender, age, chronic pulmonary disease, limited mobility, NYHA, and critical pre-operative state were significant predictors of post-cardiac surgery mortality in our population. CONCLUSION: This study suggested that the EuroSCORE II was a poor predictor for postoperative mortality in Indonesian patients who underwent cardiac surgery procedures. Therefore, EuroSCORE II may not be suitable for mortality risk prediction in Indonesian populations, and surgical planning should be decided on an individual basis.
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Kurniawaty et al. (2022) conducted an observational in Cardiac surgery (n=767). EuroSCORE II was evaluated on Postoperative mortality (AUC 0.71, 95% CI 0.65-0.77). EuroSCORE II demonstrated fair discriminatory power (AUC 0.71; 95% CI 0.65-0.77) but underestimated postoperative mortality in Indonesian cardiac surgery patients.
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