Comparison of EuroSCORE II, Original EuroSCORE, and The Society of Thoracic Surgeons Risk Score in Cardiac Surgery Patients

Ad, Niv; Holmes, Sari D.; Patel, Jigar; Pritchard, Graciela; Shuman, Deborah J.; Halpin, Linda

doi:10.1016/j.athoracsur.2016.01.105

Cited by 194 publications

(134 citation statements)

References 18 publications

(37 reference statements)

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“…A study of 11 788 patients in a single centre comparing the precision of the EuroSCORE II with EuroSCORE I and the STS risk score for operative mortality found that the EuroSCORE II was superior to the EuroSCORE I and similar to the STS risk score in predicting operative mortality . However, during their subanalysis, they also found that the discriminatory ability of the EuroSCORE II was slightly higher than that of the STS score for isolated CABG and for mitral valve surgery, whereas the STS score had greater discriminatory ability for aortic valve surgery and for CABG with concomitant valve surgery . The STS score has also been shown to be superior to the logistic EuroSCORE and EuroSCORE II in predicting outcomes when it comes to transcather aortic valve implantation (TAVI), as shown by a two centre registry of 426 TAVI procedures in Germany .…”

Section: Discussionmentioning

confidence: 97%

“…The recently updated society of thoracic surgeons (STS) risk score has been proven to be a useful tool for estimating associations between its included variables and operative mortality. A study of 11 788 patients in a single centre comparing the precision of the EuroSCORE II with EuroSCORE I and the STS risk score for operative mortality found that the EuroSCORE II was superior to the EuroSCORE I and similar to the STS risk score in predicting operative mortality . However, during their subanalysis, they also found that the discriminatory ability of the EuroSCORE II was slightly higher than that of the STS score for isolated CABG and for mitral valve surgery, whereas the STS score had greater discriminatory ability for aortic valve surgery and for CABG with concomitant valve surgery .…”

Section: Discussionmentioning

confidence: 99%

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Risk stratification for cardiac surgery: Comparison in a Hong Kong population

et al. 2019

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Aim Risk stratification is an important tool in preoperative decision‐making, counseling, informed consent and quality improvement. The European System for Cardiac Operative Risk Evaluation (logistic EuroSCORE) and EuroSCORE II were designed for the assessment of surgical risk. However, there are significant geographical and demographic differences between European and Hong Kong patients. The Queen Mary Hospital (QMH) risk score is a risk model designed to predict in‐hospital mortality for patients undergoing coronary artery bypass grafting (CABG) and valve surgery based on local data. In the present study, we compared the precision and clinical performance of the three scoring systems. Patients and Methods Data were collected prospectively from patients undergoing CABG and valve surgery between 2010 and 2015 in a single institution (n = 1693) in Hong Kong. Patients <18 years old and who had undergone congenital/aortic surgery were excluded. The receiver–operator curve (ROC) analysis was used to determine the discriminative ability of each score. Calibration was tested with the Hosmer–Lemeshow (HL) goodness‐of‐fit test. Results Observed mortality was 49/1639 (2.89 per cent). The predicted mortality rates were logistic EuroSCORE 9.23 per cent [95 per cent confidence interval (CI): 8.65–9.78 per cent], EuroSCORE II 3.87 per cent (95 per cent CI: 3.58–4.14) and QMH risk score 4.20 per cent (95 per cent CI: 4.04–4.33). The area under the ROC analysis revealed 0.849 (95 per cent CI: 0.804–0.895) for the logistic EuroSCORE, 0.87 (95 per cent CI: 0.826–0.913) for the EuroSCORE II and 0.841 (95 per cent CI: 0.788–0.895) for QMH risk score. The HL goodness‐of‐fit test showed that the QMH risk score was a good fit (P = 0.207); however, the logistic EuroSCORE (P = 0.003) and EuroSCORE II (P = 0.003) showed a poor fit. Conclusions All three scoring systems can be applied to a Chinese population with excellent risk prediction. The QMH risk score has a role in accurately predicting mortality rates in a Hong Kong population.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Risk stratification for cardiac surgery: Comparison in a Hong Kong population

et al. 2019

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“…The risk scores in cardiac surgery are intended to estimate the operative mortality according to the characteristics of the patient and the modalities of the surgery. They, therefore, have an important role in estimating the benefit/risk ratio of the interventions and for informing the patient, thus guiding the therapeutic choice …”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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Objective The main objective of this study is to evaluate the performance of the predictive model (EuroSCORE II) on a Tunisian population to validate its use in our country. Methods This is a retrospective study of data from 418 adult patients undergoing cardiac surgery with cardiopulmonary bypass between 1 January 2015 and 31 December 2016 in the department of cardiovascular and thoracic surgery of the Sahloul University Hospital of Sousse. The EuroSCORE ΙΙ is calculated using the application validated on the site http://www.euroscore.org. The performance of the score is evaluated by analyzing its discriminative power by constructing the receiver operating characteristic (ROC) curve and analyzing its calibration using the Hosmer‐Lemeshow statistics. Results The EuroSCORE II shows good discriminative power in our population with an area under the ROC curve more than 0.7 in all study groups (0.864 ± 0.032 for general cardiac surgery, 0.822 ± 0.061 for coronary surgery, 0.864 ± 0.052 for valvular surgery, and 0.900 ± 0.041 for urgent cardiac surgery). The model appears to be calibrated as well by obtaining P values above the statistical significance level of 0.05 (0.638 for general cardiac surgery, 0.543 for coronary surgery, 0.179 for valvular surgery, and 0.082 for urgent cardiac surgery). Conclusion The EuroSCORE II presents acceptable performance in our population, attested by a good discriminative power and an adequate calibration.

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“…Moreover, all cardiac surgery risk- stratification models (Euroscore, STS score…) highlight LVEF as a major determinants of periprocedural mortality [9,10] but long term surgical results in this context are not usually emphasized enough.…”

Section: Introductionmentioning

confidence: 99%

Ventricular Dysfunction in Patients with Acute Coronary Syndrome Undergoing Coronary Surgical Revascularization: Prognostic Impact on Long-Term Outcomes

et al. 2016

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BackgroundPatients with non-ST elevation acute coronary syndrome complicated by left ventricular dysfunction (LVEF) are a poor prognosis group. The aim of our study was to assess the short and long term LEVF prognostic value in a cohort of NSTE-ACS patients undergoing surgical revascularization.MethodsWe performed elective and isolated CABG on a cohort of 206 consecutive patients with LVEF≤0.40 complicating acute coronary syndrome. The case cohort was compared with a cohort of controls (LVEF>0.40) randomly selected (2:1) among patients who underwent the procedure during this period.ResultsThe Kaplan-Meier 5-year estimated survival rates for patients in the low and normal LVEF groups were 70.8% (95% confidence interval CI: 64.2–77.4) and 81.7% (95%CI: 77.8–85.6), respectively. A low LVEF was associated with both a higher all-cause (HR [95%CI] = 1.84[1.18–2.86]) and a higher cardiovascular mortality (HR = 2.07 [1.27–3.38]) during the first 12 months of follow-up. After adjustment for potential confounders, a low LVEF remained associated with a higher cardiovascular mortality only (1.87[1.03–3.38]) during the first 12 months of follow-up. After 12 months of follow-up, a low LVEF was no more associated with all-cause, nor cardiovascular mortality.ConclusionPatients with low LVEF might require more intensive care than patients with normal LVEF during the year after the surgical procedure, but once the first postoperative year over, the initial low LVEF was no more associated with long term mortality.

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Comparison of EuroSCORE II, Original EuroSCORE, and The Society of Thoracic Surgeons Risk Score in Cardiac Surgery Patients

Cited by 194 publications

References 18 publications

Risk stratification for cardiac surgery: Comparison in a Hong Kong population

Risk stratification for cardiac surgery: Comparison in a Hong Kong population

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

Ventricular Dysfunction in Patients with Acute Coronary Syndrome Undergoing Coronary Surgical Revascularization: Prognostic Impact on Long-Term Outcomes

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