Clinical Performance of the EuroSCORE II Compared with the Previous EuroSCORE Iterations

Velicki, Lazar; Cemerlic-Adjic, Nada; Pavlović, Katica; Mihajlović, Bojan; Banković, Dragić; Mihajlovic, B.; Fabri, M

doi:10.1055/s-0034-1367734

Cited by 18 publications

(7 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Usually, patients who have undergone valvular surgeries have greater surgical risks than those who have undergone CABG. 19 In our study, patients with only ischemic heart disease were also protected in terms of the occurrence of a poor evolution. Therefore, our population is similar to the population encountered in current practice, including patients at low operating risk and those at higher risk.…”

Section: Discussionsupporting

confidence: 46%

<p>Postoperative Delirium is a Risk Factor of Poor Evolution Three Years After Cardiac Surgery: An Observational Cohort Study</p>

Labaste

Porterie

Bousquet

et al. 2020

CIA

View full text Add to dashboard Cite

Background After cardiac surgery, postoperative delirium (POD) is common and is associated with long-term changes in cognitive function. Impact on health-related quality of life (QOL) and long-term dependence are not well known. This aim of this study is to evaluate the role of POD in poor evolution at three years after surgery including poor QOL and dependence and mortality. Patients and Methods We enrolled and followed 173 patients 60 years of age or older who were planning to undergo cardiac surgery with cardiopulmonary bypass. The primary composite outcome was death of any causes, or patients with either a loss of QOL (evaluated with of EuroQuol verbal 5D EQ5D less than 50), or a loss of two points on the instrumental activities of daily living occurring three years after surgery. POD was diagnosed with the use of Confusion Assessment Method. Multivariate logistic regression was performed. Results At three years, 74 patients (42.8%) had a poor evolution. Independent risk factors in poor patient evolution were sex (female gender; OR: 3.6; 95%CI: 1.45–8.7; p =0.006), metabolic status (diabetic patients; OR: 4; 95%CI: 1.6–10.2; p =0.002), Euroscore 2 (Euroscore 2 >1.5; OR: 5.2; 95%CI: 1.7–15.4; p =0.003) and POD (OR: 3.3; 95%CI 1.4–7.8; p =0.006). Coronary disease was protective (OR: 0.3; 95%CI: 0.14–0.71; p =0.006). Conclusion After cardiac surgery, POD significantly altered patient evolution and increased risk of dependence and loss of QOL.

show abstract

Section: Discussionsupporting

confidence: 46%

<p>Postoperative Delirium is a Risk Factor of Poor Evolution Three Years After Cardiac Surgery: An Observational Cohort Study</p>

Labaste

Porterie

Bousquet

et al. 2020

CIA

View full text Add to dashboard Cite

show abstract

“…Two studies also analysed the performance of the ESII according to type of surgery using the same categories we used. Curiously, although the ESII performed well, these studies found that the ESI was the overall best performing risk model in elective surgery [ 24 , 25 ]. This is due to a higher mortality rate than in our cohort.…”

Section: Discussionmentioning

confidence: 99%

Prospective validation of the EuroSCORE II risk model in a single Dutch cardiac surgery centre

et al. 2018

View full text Add to dashboard Cite

ObjectiveThe EuroSCORE I was one of the most frequently used pre-operative risk models in cardiac surgery. In 2011 it was replaced by its successor the EuroSCORE II. This study aims to validate the EuroSCORE II and to compare its performance with the EuroSCORE I in a Dutch hospital.MethodsThe EuroSCORE II was prospectively validated in 2,296 consecutive cardiac surgery patients between 1 April 2012 and 1 January 2014. Receiver operating characteristic curves on in-hospital mortality were plotted for EuroSCORE I and EuroSCORE II, and the area under the curve was calculated to assess discriminative power. Calibration was assessed by comparing observed versus expected mortality. Additionally, analyses were performed in which we stratified for type of surgery and for elective versus emergency surgery.ResultsThe observed mortality was 2.4% (55 patients). The discriminative power of the EuroSCORE II surpassed that of the EuroSCORE I (area under the curve EuroSCORE II 0.871, 95% confidence interval (CI) 0.832–0.911; area under the curve additive EuroSCORE I 0.840, CI 0.798–0.882; area under the curve logistic EuroSCORE I 0.761, CI 0.695–0.828). Both the additive and the logistic EuroSCORE I overestimated mortality (predictive mortality additive EuroSCORE I median 5.0%, inter-quartile range 3.0–8.0%; logistic EuroSCORE I 10.7%, inter-quartile range 5.8–13.9), while the EuroSCORE II underestimated mortality (median 1.6%, inter-quartile range 1.0–3.5). In most stratified analyses the EuroSCORE II performed better.ConclusionOur results show that the EuroSCORE II produces a valid risk prediction and outperforms the EuroSCORE I in elective cardiac surgery patients.

show abstract

“…This contradiction is also reflected in the current risk assessment scores. More specifically, the logistic EuroSCORE I does not include the patient factor diabetes, whereas the Society of Thoracic Surgery (STS) Score utilizes the patient factor diabetes, independently of the applied therapy; in the EuroSCORE II, DM on insulin is a patient-related factor considered to have satisfactory performance in predicting perioperative as well as 30-day mortality [20–22]. The aim of this study was to investigate the effect of diabetes mellitus treated with insulin and oral antidiabetic drugs on clinical outcomes after TAVI.…”

Section: Introductionmentioning

confidence: 99%

The association of diabetes mellitus treated with oral antidiabetic drugs and insulin with mortality after transcatheter valve implantation: a 3-year follow-up of the TAVIK registry

Tzamalis

Herzberger

Bergmann

et al. 2019

Cardiovasc Diabetol

View full text Add to dashboard Cite

Background Diabetes mellitus (DM) on insulin is a patient-related factor in the assessment of surgical risk based on the EuroSCORE II and, as such, it confers additional risk on outcomes after transcatheter aortic valve implantation (TAVI). The aim of this study was to investigate the effect of diabetes mellitus treated with insulin and oral antidiabetic drugs on clinical outcomes after TAVI. Methods This study is an analysis of 2000 patients who underwent TAVI between 2008 and 2015. Patients were stratified post hoc into the following categories: without diabetes (n = 1337), with diabetes treated with oral antidiabetic drugs (OAD; n = 387) and with diabetes treated using insulin (n = 276). Results There was no significant difference in device success (89.5% vs 89.4% vs 88.8%, adjusted odds ratio (adjOR) 1.10 [95% confidence interval (CI) 0.64–1.91]) and VARC-2-defined major complications among the three groups of patients (without DM, OAD, and insulin, respectively). Minor but not major or disabling strokes (adjOR 2.19; 95% CI 1.11–4.3) and overall renal complications (but not stage 2/3 alone) (adjOR 1.46; 95% CI 1.18–1.81) were more common in patients with diabetes than in those without diabetes. Insulin-treated patients had a significantly lower survival rate than that of patients with orally treated diabetes and of those without diabetes at 1 year (75.7% vs. 84.5% vs 84.7%, pairwise p < 0.01) and 3 years (56.9% vs. 65.9% vs. 67.9%, adj. p < 0.05) after TAVI. However, insulin-treated diabetes was not identified as an independent risk factor for higher mortality in the first (HR 1.29; 95% CI 0.97–1.72, p = 0.084) and 3rd years (HR 1.21; 95% CI 0.98–1.49; p = 0.079) after multivariable adjustment. Conclusions Although insulin-dependent DM is an established component of surgical risk assessment, it was not identified as an independent factor associated with reduced survival in TAVI. DM treated with oral antidiabetic drugs or insulin may have less role in decision making of treatment in TAVI candidates.

show abstract

Clinical Performance of the EuroSCORE II Compared with the Previous EuroSCORE Iterations

Cited by 18 publications

References 22 publications

<p>Postoperative Delirium is a Risk Factor of Poor Evolution Three Years After Cardiac Surgery: An Observational Cohort Study</p>

<p>Postoperative Delirium is a Risk Factor of Poor Evolution Three Years After Cardiac Surgery: An Observational Cohort Study</p>

Prospective validation of the EuroSCORE II risk model in a single Dutch cardiac surgery centre

The association of diabetes mellitus treated with oral antidiabetic drugs and insulin with mortality after transcatheter valve implantation: a 3-year follow-up of the TAVIK registry

Contact Info

Product

Resources

About