EuroSCORE II Validation as a Method for Cardiac Surgery Risk Stratification in Mexico

Abstract

Objective: To Validate the EuroSCORE II as a method for cardiac surgery risk stratification in Mexican adult population. Methods: We included adult patients undergoing to cardiac surgery, in order to determine the predictive value of EuroSCORE II on morbidity and mortality risk. Continuous variables are presented as mean ± SD or median with its interquartile range as appropriate; categorical variables were described as n, % or rate. To validate the EuroSCORE II scale, the assessment was done with Hosmer- Lemeshow (HL) test. In terms of discrimination, we used the features of the receiver operation characteristic (ROC) curves. Results: They were 704 patients, grouped into five categories: simple (one vessel) Coronary Artery Bypass Grafting (CABG) surgery, n= 299 (43%) cases. CABG revascularization (two or more vessels), n= 208 (30%). Double Procedure (CABG + valve replacement) 174 (25%) cases. Triple procedure (CABG + valve + aorta surgery) 23 (3.3%) patients. The mortality observed within 30 days of the surgery was 88 (12.5%). Meanwhile, the mean of the expected mortality predicted by EuroSCORE II was 3.63 ± 5.91 (95% CI: 3.19-4.06). The EuroSCORE II scale presented a good capacity for discrimination in the studied population reaching an area under the ROC curve of 0.821 (p < 0.000, 95% CI: 0.772-0.871). A calibration for the scale measured through logistic regression with goodness of adjustment of Hosmer-Lemeshow was determined (χ2 = 17.74, p = 0.64). Conclusion: EuroSCORE II showed moderate discrimination ability in general. The scale can be useful to identify some problems in our hospital, however, the mortality rate might be underestimated. Key words: Euroscore II; Adult Cardiac Surgery; Surgical Risk