Key result
The EuroSCORE logistic model correlated better with the risk of in-hospital death than EuroSCORE II among patients undergoing coronary artery bypass grafting or valvular replacement.
Why the study?
EuroSCORE logistic and EuroSCORE II are both used to predict in-hospital mortality after cardiac surgery, but they are based on different populations and medical approaches.
Does the EuroSCORE logistic or EuroSCORE II model better predict in-hospital death and prolonged ICU stay in patients undergoing CABG, AVR, or MVR?
Observational (n=586)
No
Does the EuroSCORE logistic or EuroSCORE II model better predict in-hospital death and prolonged ICU stay in patients undergoing CABG, AVR, or MVR?
The logistic EuroSCORE correlates better with real-life in-hospital mortality than EuroSCORE II, which tends to underestimate mortality risk in patients undergoing CABG or valve replacement.
Suggests caution when using EuroSCORE II for surgical risk stratification; leaves open.
Nowadays, both the European System for Cardiac Operative Risk Evaluation (EuroSCORE) logistic (ESL) and EuroSCORE II (ESII) models are used worldwide in predicting in-hospital mortality after cardiac operation. However, these scales are based on different populations and represent different medical approaches. The aim of the study was to assess the effectiveness of the ESL and the ESII risk scores in predicting in-hospital death and prolonged hospitalization in intensive care unit (ICU) after coronary artery bypass grafting (CABG), aortic valve replacement (AVR), and mitral valve replacement (MVR) by comparison of an estimated risk and a real-life observation at a reference cardiac surgery unit.This retrospective study was based on medical records of patients who underwent a CABG, AVR, or MVR at a reference cardiac surgery unit in a 2-year period. Primary endpoint was defined as in-hospital death. Secondary endpoint was a prolonged hospitalization at the ICU, defined as longer than 3 days.The study encompassed 586 patients [114 (23.1%) female, mean age 65.8 ± 10.5 years], including 493 patients undergoing CABG, 66 patients undergoing AVR, and 27 patients undergoing MVR. The ESL and ESII risk scores were higher in MVR subgroup (31.7% ± 30.5% and 15.3% ± 19.4%) and AVR subgroup (9.7% ± 11.6% and 3.2% ± 4.2%) than in CABG subgroup (6.9% ± 10.4% and 2.5% ± 4.1%; P < .001). Subgroups of patients were significantly different in terms of clinical, biochemical, and echocardiography factors. Primary endpoint occurred in 36 (6.1%) patients: 21 (4.3%), 7 (10.6%), and 8 (29.7%) in CABG, AVR, and MVR subgroups, respectively. The ESII underestimated the risk of mortality. Secondary endpoint occurred in 210 (35.8%) patients: 172 (34.9%), 22 (33.4%), and 16 (59.3%) in CABG, AVR, and MVR subgroups, respectively.In the study, the perioperative risk estimated with the ESL and the ESII risk scores was compared with a real-life outcome among over 500 patients. Regardless of the type of surgery, result in the ESL was better correlated with the risk of in-hospital death.
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Czub et al. (2018) conducted an observational in Coronary artery or valvular disease (n=586). EuroSCORE logistic (ESL) and EuroSCORE II (ESII) was evaluated on In-hospital death. The EuroSCORE logistic model correlated better with the risk of in-hospital death than EuroSCORE II among patients undergoing coronary artery bypass grafting or valvular replacement.
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