Mortality in low- and very low-risk patients undergoing cardiac surgery: Evaluation according to the EuroSCORE II as a new standard

Borracci, Raúl A.; Rubio, Miguel A.; Baldi, Julio; Guerrero, Rodolfo A. Ahuad; Mauro, Víctor

doi:10.5603/cj.a2015.0028

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…We should also mention that the higher Euro-Score rates in the OPCAB presented in our study were still <2%, which is considered to be in the low-risk range (17). Despite the higher EuroScore Class in the OPCAB cohort, there was no difference in the postoperative survival between the groups: the overall 30-day survival was 100%, which shows that the OPCAB procedure is safe and non-inferior in mortality for these groups of patients.…”

Section: Discussionmentioning

confidence: 45%

On-pump versus off-pump coronary artery bypass surgery for multi-vessel coronary revascularization

et al. 2020

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Background: This study aims to compare the operative and postoperative results of on-pump (ONCAB) and off-pump (OPCAB) coronary artery bypass surgery (CABG) for multi-vessel coronary revascularization (≥4 anastomoses). Methods: From May 2018 to August 2019, a total of 120 patients (22.5% women, mean age 61.5±8.4 years) received either ONCAB (Group 1, n=60) or OPCAB (Group 2, n=60) for multi-vessel coronary artery disease (CAD). Preoperative left ventricular (LV) ejection fraction (EF) was 53.1%±8.4%.Median EuroSCORE II was 1.59 (interquartile range, 1.01-2.54). The median number of performed coronary anastomoses was 4 (interquartile range, 4-5), with equal distribution in both groups (P=0.4). All procedures were performed by highly experienced surgeons. The primary endpoints were overall survival at 30 days and freedom from severe adverse events (SAE), which included myocardial infarction (MI), coronary artery re-operation, and re-thoracotomy, caused by bleeding and stroke. Results: The overall survival in both groups was 100% with no intraoperative OPCAB-to-on-pump conversion. The median procedure time was 169 min (interquartile range, 150-179 min) for Group 1 and 183 min (interquartile range, 169-205 min) for Group 2 (P<0.001). The overall freedom from SAE numbered 93.3% (98.3% vs. 88.3%, P=0.030). Postoperative MI rate was 2.5% (n=3) with no significant difference for either group (0 vs. 5.0%, P=0.100). One MI patient underwent a re-operation, and two other patients received a conservative treatment. A total of 2.5% (n=3) of patients underwent a re-thoracotomy on account of bleeding (0 vs. 5.0%, P=0.100); no anastomosis-related bleeding was detected. Blood transfusion was applied in 31.7% of patients (38.3% vs. 25.0%, P=0.090). A total of 1.7% of patients (1.7% vs. 1.7%, P=0.800) developed a stroke. Ventilation time, intensive care unit stay, and hospital stay were similar in both groups. Conclusions: ONCAB showed superior freedom from SAE and shorter procedure times when compared to OPCAB for multi-vessel coronary artery revascularization. 5640Zubarevich et al. On-pump versus off-pump for multi-vessel coronary revascularization

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Section: Discussionmentioning

confidence: 45%

On-pump versus off-pump coronary artery bypass surgery for multi-vessel coronary revascularization

et al. 2020

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“…In this issue of "Cardiology Journal", the Hospital de Clínicas of Buenos Aires group [11] publishes a validation of EuroSCORE II in low-and verylow-risk patients. A validation of EuroSCORE II in this group of patients is very interesting because it has been less studied than in high-risk patients.…”

Section: Article P 495mentioning

confidence: 99%

EuroSCORE II, is its predictive capacity influenced by the patient’s risk profile

Herreros

Bustamante‐Munguira

2015

Cardiol J.

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Machine learning-based risk profile classification of patients undergoing elective heart valve surgery

Bodenhofer

Haslinger-Eisterer

Minichmayer

et al. 2021

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES Machine learning methods potentially provide a highly accurate and detailed assessment of expected individual patient risk before elective cardiac surgery. Correct anticipation of this risk allows for the improved counselling of patients and avoidance of possible complications. We therefore investigated the benefit of modern machine learning methods in personalized risk prediction for patients undergoing elective heart valve surgery. METHODS We performed a monocentric retrospective study in patients who underwent elective heart valve surgery between 1 January 2008 and 31 December 2014 at our centre. We used random forests, artificial neural networks and support vector machines to predict the 30-day mortality from a subset of 129 available demographic and preoperative parameters. Exclusion criteria were reoperation of the same patient, patients who needed anterograde cerebral perfusion due to aortic arch surgery and patients with grown-up congenital heart disease. Finally, the cohort consisted of 2229 patients with a 30-day mortality of 3.86% (86 of 2229 cases). This trial has been registered at clinicaltrials.gov (NCT03724123). RESULTS The final random forest model trained on the entire data set provided an out-of-bag area under the receiver operator characteristics curve (AUC) of 0.839, which significantly outperformed the European System for Cardiac Operative Risk Evaluation (EuroSCORE) (AUC = 0.704) and a model trained only on the subset of features EuroSCORE uses (AUC = 0.745). CONCLUSIONS Advanced machine learning methods can predict outcomes of valve surgery procedures with higher accuracy than established risk scores based on logistic regression on pre-selected parameters. This approach is generalizable to other elective high-risk interventions and allows for training models to the cohorts of specific institutions

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Mortality in low- and very low-risk patients undergoing cardiac surgery: Evaluation according to the EuroSCORE II as a new standard

Abstract: (Cardiol J 2015; 22, 5: 495-500)

Cited by 4 publications

References 11 publications

On-pump versus off-pump coronary artery bypass surgery for multi-vessel coronary revascularization

On-pump versus off-pump coronary artery bypass surgery for multi-vessel coronary revascularization

EuroSCORE II, is its predictive capacity influenced by the patient’s risk profile

Machine learning-based risk profile classification of patients undergoing elective heart valve surgery

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