Validation of EuroSCORE II in Patients Undergoing Coronary Artery Bypass Surgery

Biancari, Fausto; Vasques, Francesco; Mikkola, Reija; Martín, Marta Jiménez; Lahtinen, Jarmo; Heikkinen, Jouni

doi:10.1016/j.athoracsur.2012.02.064

Cited by 133 publications

(97 citation statements)

References 12 publications

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“…However, contrary to previous findings, 23,25,26 it did not appear to be equally reliable for predicting in-hospital morbidity. One possible explanation is that EuroSCORE II exclusively consists of preoperative and intraoperative parameters, whereas postoperative events may have influenced the duration of mechanical ventilation and LOS in the CSICU in our study.…”

Section: Testcontrasting

confidence: 55%

Scoring Systems for Outcome Prediction in a Cardiac Surgical Intensive Care Unit: A Comparative Study

Exarchopoulos

Charitidou

Dedeilias

et al. 2015

American Journal of Critical Care

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A closed-book, multiple-choice examination following this article tests your under standing of the following objectives:1. Compare and contrast 5 scoring systems and their ability to predict morbidity and mortality in the cardiac patient population. 2. Identify preoperative, intraoperative, and postoperative variables when using a prospective study. 3. Describe the performance of each scoring system. Methods Consecutive patients admitted to a cardiac surgical intensive care unit (CSICU) were prospectively studied. Data on the preoperative condition, intraoperative parameters, and postoperative course were collected. EuroSCORE II, CASUS, and scores from 3 general severityscoring systems (APACHE II, SAPS II, and SOFA) were calculated on the first postoperative day. Clinical outcome was defined as 30-day mortality and in-hospital morbidity. Results A total of 150 patients were included. Thirty-day mortality was 6%. CASUS was superior in outcome prediction, both in relation to discrimination (area under curve, 0.89) and calibration (Brier score = 0.043, c 2 = 2.2, P = .89), followed by EuroSCORE II for 30-day mortality (area under curve, 0.87) and SOFA for morbidity (Spearman ρ = 0.37 and 0.35 for the CSICU length of stay and duration of mechanical ventilation, respectively; Wilcoxon W = 367.5, P = .03 for probability of readmission to CSICU). Conclusions CASUS can be recommended as the most reliable and beneficial option for benchmarking and risk stratification in cardiac surgery patients.

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Section: Testcontrasting

confidence: 55%

Scoring Systems for Outcome Prediction in a Cardiac Surgical Intensive Care Unit: A Comparative Study

Exarchopoulos

Charitidou

Dedeilias

et al. 2015

American Journal of Critical Care

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“…With the advances in surgical technology, the proportion of high-risk patients with an additive EuroSCORE over 6 undergoing CABG appears to be on the increase. [1][2][3][4] Conventional coronary artery bypass grafting (CCABG), using cardiopulmonary bypass (CPB) with cardioplegic arrest and aortic cross-clamp, has been the standard procedure for surgical revascularization. Off-pump coronary artery bypass grafting (OPCAB), avoiding the use of CPB, has attracted the interest of an increasing number of surgeons and patients, and has assumed an increasing role in surgical practice.…”

mentioning

confidence: 99%

On-Pump Versus Off-Pump Coronary Artery Bypass Surgery in High-Risk Patients

Mei

Wang

et al. 2014

Int. Heart J.

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SummaryThis study aimed to evaluate on-pump versus off-pump coronary artery bypass grafting (CABG) in patients with a high-risk operative profile.The pre-, intra-and post-operative data of high-risk patients with additive European system for cardiac operative risk evaluation (additive Euro-SCORE) over 6 undergoing isolated CABG from January 2008 to December 2011 in this center were investigated and retrospectively analyzed. Using the propensity score-matching method, those patients with similar pre-and intra-operative characteristics were selected and their early clinical outcomes were compared.From January 2008 to December 2011, 485 consecutive patients (398 males, with a mean age of 70.9 ± 9.0 years) whose additive Euro-SCORE was over 6 were entered into this study. Off-pump coronary bypass grafting (OPCAB) was performed in 58.1% (n = 282), and the remaining patients underwent conventional coronary artery bypass grafting (CCABG). After propensity score matching, the two groups of patients (90 OPCAB patients versus 90 CCABG patients) were similar with regard to pre-and intra-operative characteristics but not duration of surgical procedure. No significant differences in hospital mortality were found. Compared to CCABG, high-risk patients undergoing OPCAB had significantly lower prevalence of postoperative respiratory failure and postoperative renal failure (6.7% versus 17.8%, P = 0.0386, 5.6% versus 16.7%, P = 0.0307, respectively). Through multivariate logistic regression analysis, type of procedure (CCABG versus OPCAB), as an independent risk factor, had an impact on the postoperative respiratory failure (OR = 2.36, 95%CI 1.44-4.97, P = 0.0312) and postoperative renal failure (OR = 2.86, 95%CI 1.61-5.81, P = 0.0037).Compared with CCABG, OPCAB reduced postoperative respiratory and renal morbidity in high-risk patients. (Int Heart J 2014; 55: 484-488)

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“…Another index for assessing discriminatory power used in this paper was the Brier score, which is the quadratic difference between the predicted mortality rate and the observed outcome calculated for each patient. It was assumed that it ranged from 0 to 0.25 for a perfect model [5][6][7]. The Hosmer-Lemeshow goodness-of-fit test, which compares the observed to predicted values by decile of predicted probability, was calculated to explore the calibration of each of the above-mentioned models.…”

Section: Resultsmentioning

confidence: 99%

“…For our CABG patients, this value was 5.33%. Biancari et al [5] and Mediratta et al [14] reported mortality rates of 3.7% and 1.1%, respectively (for patients under the age of 65 years). The lower mortality rate in these groups of CABG patients may be connected with the demographic profile of their cohorts -e.g.…”

Section: Discriminatory Powermentioning

confidence: 99%

“…The report from Finland (1027 patients) presented better accuracy of EuroSCORE II (ESII: AUC 0.852 vs. logES: AUC 0.838) in a group of patients undergoing CABG [5]. Our calculations were different from those in that research, and logES was non-significantly higher than ESII (AUC: 0.728 vs. 0.726, p > 0.05, Brief score: 0.050, 0.052, respectively).…”

Section: Discriminatory Powermentioning

confidence: 99%

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EuroSCORE II does not show better accuracy nor predictive power in comparison to original EuroSCORE: a single-centre study

et al. 2016

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A b s t r a c tBackground: EuroSCORE is used to predict postoperative mortality in patients undergoing cardiac surgery. Its updated version was published in 2011. Aim:To assess whether EuroSCORE II (ESII) predicts more accurately postoperative mortality after cardiac surgery in comparison with additive (addES) and logistic EuroSCORE (logES). Methods:A total of 461 patients (aged 21-88 years, 63.4% of men) who underwent cardiac surgery (December 2010 -June 2011) were included into the prospective research. For each patient ESII, addES and logES were calculated. Accuracy, calibration, and clinical performance of these models were assessed with receiver operating characteristics analyses using the area under the curve and the Hosmer-Lemeshow test. Out of this population, a group of 300 coronary artery bypass grafting (CABG) patients (aged 42-85 years, 73% of men) was selected and statistically analysed using the same methods. Results:The mortality rate was 5.21%. Predicted mortality rates were as follows: addES 4.68%, logES 4.57%, and ESII 1.89%; the accuracy was: 0.589, 0.728, and 0.726, respectively. Only logES presented good predictive power (Hosmer-Lemeshow test: c 2 = 12.79, p = 0.12). In the CABG patients, the postoperative mortality rate was 5.33%. Predicted mortality rates were as follows: addES 4.69%, logES 4.59%, and ESII 1.88%; the accuracy was: 0.512, 0.691, and 0.687, respectively. In the Hosmer-Lemeshow test also logES presented good predictive power (c 2 = 10.72, p = 0.218). Conclusions:EuroSCORE II did not estimate mortality risk better in comparison to its previous versions, in the entire studied population or in the CABG patients. On the basis of the analysed data, it seems that the closest to the actual risk of death for the Polish population is the EuroSCORE logistic model. [1] is used to predict operative mortality in patients undergoing cardiac surgery. The scoring system was prepared using the most reliable and objective risk factors out of 97 risk factors collected from nearly 20,000 patients from 128 hospitals in eight European countries. All of the selected risk factors were divided into three groups: patient-related, cardiac-related, and operative-related factors. If

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Validation of EuroSCORE II in Patients Undergoing Coronary Artery Bypass Surgery

Cited by 133 publications

References 12 publications

Scoring Systems for Outcome Prediction in a Cardiac Surgical Intensive Care Unit: A Comparative Study

Scoring Systems for Outcome Prediction in a Cardiac Surgical Intensive Care Unit: A Comparative Study

On-Pump Versus Off-Pump Coronary Artery Bypass Surgery in High-Risk Patients

EuroSCORE II does not show better accuracy nor predictive power in comparison to original EuroSCORE: a single-centre study

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