CARDIAC SURGERY Validation of EuroSCORE II risk model for coronary artery bypass surgery in high-risk patients

Abstract

IntroductionDetermining operative mortality risk is mandatory for adult cardiac surgery. Patients should be informed about the operative risk before surgery. There are some risk scoring systems that compare and standardize the results of the operations. These scoring systems needed to be updated recently, which resulted in the development of EuroSCORE II. In this study, we aimed to validate EuroSCORE II by comparing it with the original EuroSCORE risk scoring system in a group of high-risk octogenarian patients who underwent coronary artery bypass grafting (CABG).Material and methodsThe present study included only high-risk octogenarian patients who underwent isolated coronary artery bypass grafting in our center between January 2000 and January 2010. Redo procedures and concomitant procedures were excluded. We compared observed mortality with expected mortality predicted by EuroSCORE (logistic) and EuroSCORE II scoring systems.ResultsWe considered 105 CABG operations performed in octogenarian patients between January 2000 and January 2010. The mean age of the patients was 81.43 ± 2.21 years (80-89 years). Thirty-nine (37.1%) of them were female. The two scales showed good discriminative capacity in the global patient sample, with the AUC (area under the curve) being higher for EuroSCORE II (AUC 0.772, 95% CI: 0.673-0.872). The goodness of fit was good for both scales.ConclusionsWe conclude that EuroSCORE II has better AUC (area under the ROC curve) compared to the original EuroSCORE, but both scales showed good discriminative capacity and goodness of fit in octogenarian patients undergoing isolated coronary artery bypass grafting.

External validation of the European System for Cardiac Operative Risk Evaluation II in a Tunisian population

“…Only a few series offer results comparable to ours, such as that of Stavridis et al (2.23) or that of Kar et al (1.94) for any type of cardiac surgery included, or that of Laurent et al for aortic valve replacement or that of Kalender et al (6.77) for emergency coronary surgery or that of De Oliveira et al and that of Taamallah et al for surgery of infectious endocarditis.…”

Supplementing prediction by EuroSCORE with social and patient‐reported measures among patients undergoing cardiac surgery

“…The risk score calculations available for this study are calculated based on EuroSCORE I and not the updated EuroSCORE II, why there is a risk of misclassification of high‐risk patients due to use of the outdated model; however, EuroSCORE I has been found to overestimate 45 and EuroSCORE II to underestimate mortality 4,46,47 . It is, therefore, reasonable to assume that the potential improvement of the model is not attributable to the choice of EuroSCORE model.…”

“…However, we 45 and EuroSCORE II to underestimate mortality. 4,46,47 It is, therefore, reasonable to assume that the potential improvement of the model is not attributable to the choice of EuroSCORE model.…”

The operative risk stratification models in cardiac surgery: EuroSCORE II model - risk groups categorization

“…In their patient population, for the very high risk patients (observed mortality 11%), EuroSCORE II predicted mortality was 6.5% (significant underestimation). Kalender et al 19 reported octagenarians (105 patients) who underwent isolated coronary artery surgery, but the old additive EuroSCORE was used for risk group categorisation. The discriminative power of Euro-SCORE II model was not shown for risk group categories in any of aforementioned papers.…”