Key result
EuroSCORE II accurately predicted mortality for isolated repeated aortic valve replacement with an AUC of 0.86, outperforming both the original EuroSCORE and the STS score.
Why the study?
Does EuroSCORE II accurately predict mortality in patients undergoing isolated repeated aortic valve replacement compared to EuroSCORE and STS score?
Observational (n=78)
No
Does EuroSCORE II accurately predict mortality in patients undergoing isolated repeated aortic valve replacement compared to EuroSCORE and STS score?
Effect estimate: AUC 0.86 (95% CI 0.76-0.93)
Absolute Event Rate: 0.86% vs 0.74%
p-value: p=<0.0001
EuroSCORE II provides a highly accurate mortality prediction for patients undergoing isolated redo aortic valve replacement, significantly outperforming both the original EuroSCORE and the STS score.
May aid risk stratification in isolated redo AVR; extends EuroSCORE II validation but requires prospective confirmation.
OBJECTIVE: We evaluated the predictive power of the EuroSCORE, EuroSCORE II and Society of Thoracic Surgeons (STS) score for isolated redo aortic valve replacement. MATERIALS AND METHODS: 78 consecutive patients underwent the aforementioned procedure mainly with a stentless valve prosthesis at our institution. Observed mortality was compared to the predicted mortality, Receiver Operating Characteristics (ROC) curves were calculated and the area under the curve (AUC) analyzed. RESULT: Observed mortality was 11.5%. EuroSCORE and EuroScore II predicted a mortality of 28.2 ± 21.6% (p <0.001) and 10.2 ± 11.8% (p = 0.75), respectively. AUC of the EuroSCORE was 0.74 (95% CI: 0.62-0.83), p = 0.009 and of the EuroSCORE II 0.86 (95% CI: 0.76-0.93), p <0.0001. Optimal Youden index of the EuroSCORE II was 0.59 referring to a predicted mortality of 9.9% (sensitivity: 77.8% and specificity: 81.2%). Predicted mortality of STS score was 17.8 ± 10.6% (p = 0.08) and AUC was 0.64 (95% CI: 0.53-0.75), p = 0.06. CONCLUSION: EuroSCORE II calculation was not only superior to EuroSCORE and STS score but led to a very realistic mortality prediction for this special procedure at our institution. A EuroSCORE II greater 10 should encourage to consider an alternative treatment.
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Holinski et al. (2015) conducted an observational in Isolated repeated aortic valve replacement (n=78). EuroSCORE II vs. EuroSCORE and STS score was evaluated on Area under the curve (AUC) for mortality prediction (AUC 0.86, 95% CI 0.76-0.93, p=<0.0001). EuroSCORE II accurately predicted mortality for isolated repeated aortic valve replacement with an AUC of 0.86, outperforming both the original EuroSCORE and the STS score.
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