Performance of the EuroSCORE II and the STS score for cardiac surgery in octogenarians

Abstract

Background: We aimed to investigate the predictive value of Society of Thoracic Surgeons (STS) and European System for Cardiac Operative Risk Evaluation (EuroSCORE II) scores for mortality in octogenarian cardiac surgery patients. Methods: Between January 2016 and December 2019, cardiac operations performed in 116 octogenarian patients (73 males, 43 females; mean age: 82.9±3.1 years; range, 80 to 97 years) were retrospectively analyzed. The patients with and without mortality were compared for their demographic and operative factors. The STS and EuroSCORE II scores, and observed mortality rates were assessed. Results: Mean STS score was 3.7±11.1 and mean EuroSCORE II was 5.2±5.4. For any operation type, the mean EuroSCORE II was significantly higher (8.1±7.4 vs. 4.1±4.0, respectively; p=0.006) in the patients with mortality. For elective operations, the mean EuroSCORE II was higher in cases with mortality (7.2±7.3 vs. 3.7±3.9, respectively; p=0.006); however, for urgent cases, there was no significant difference between the scores. Using the receiver operating characteristic curve, the EuroSCORE II had a higher area under the curve for all cases and elective cases than the STS scores. Conclusion: The EuroSCORE II performed better than the STS score for mortality prediction in octogenarians, whereas the predictions of either scoring system was unsatisfactory for urgent surgery and combined procedures. Population-based validation studies are needed for a better risk scoring system in this age group.

CAROTIDSCORE.RU—The first Russian computer program for risk stratification of postoperative complications of carotid endarterectomy

“…[9][10][11]15,16 The Euro SCORE scale, based on an additive system obtained using a logistic regression model, was developed on data collected in 1995 and registered in 1999 to predict the risk of surgical complications in the 30-day postoperative period. [9][10][11] However, the predictive power of any risk stratification algorithms may change over time as a result of changes in the epidemiology of cardiovascular diseases, modernization of surgical treatment methods, instrumentation, indications for operations. 15,16 It has been shown through a high-risk group assessment that Euro SCORE is not able to provide an accurate assessment of the possible development of complications.…”

“…15,16,27,28 To overcome these limitations, an updated version of the scale was created-Euro SCORE II, modeled in modern conditions, in a group of 22,381 patients in 150 clinics from 43 countries. [9][10][11][12][13] However, a number of researchers agree that Euro SCORE II underestimates the mortality rate and risks of complications in the high-risk group of patients, and also does not take into account the anatomical component of atherosclerotic lesions of the coronary arteries. 15,16,27,28 The Euro SCORE scale took into account the following patient risk factors: age, height, sex, body weight, the presence of concomitant pathology (chronic obstructive pulmonary disease, MPA), myocardial contractility, the urgency of the operation, the presence of endocarditis, previous cardiac surgery, pulmonary artery pressure, features operations (time of cardiopulmonary bypass, time of aortic crossclamping, time of circulatory arrest), critical condition of the patient before surgery, renal dysfunction, decreased plasma protein level, symptoms of the disease (functional class of angina pectoris and heart failure).…”

“…[6][7][8] Currently, there are two popular interactive calculators for determining the probability of developing adverse cardiovascular events after interventions on the cardiovascular system-Euro SCORE II and STS Score. [9][10][11][12][13] However, due to their versatility, they do not meet the requirements of personalized medicine. 14,15 Recently, there has been a growing trend of creating such computer programs for each type of revascularization separately.…”

Gastrointestinal bleeding during the transcatheter aortic valve replacement perioperative period: A Review

“…Assessing the risk of perioperative bleeding is important; therefore, many risk score questionnaires, such as the Society of Thoracic Surgeons score and Euro SCORE II score, have been widely used to predict the mortality of patients undergoing cardiac surgery. [36][37][38] Additionally, there are some questionnaires for evaluating the degree of GI bleeding, such as the Rockall score and Glasgow Blatchford score. Additionally, it is necessary to assess the coagulation function.…”

Minimum heart rate and mortality after cardiac surgery: retrospective analysis of the Multi-parameter Intelligent Monitoring in Intensive Care (MIMIC-III) database

“…Several studies previously developed Euroscore I (EI), II (EII), STS score, and SAPS III to evaluate the prognosis of patients with cardiac surgery. However, the predictions of these scoring systems have been unsatisfactory across different cardiac surgery procedures and in different populations 7 – 10 . Therefore, it is important to identify a faster and easier measurable parameter for high-risk patients after cardiac surgery.…”