The Impact of EuroSCORE II Risk Factors on Prediction of Long-Term Mortality

Barili, Fabio; Pacini, Davide; D’Ovidio, Mariangela; Dang, Nicholas C.; Alamanni, Francesco; Bartolomeo, Roberto Di; Grossi, Claudio; Davoli, Marina; Fusco, Danilo; Parolari, Alessandro

doi:10.1016/j.athoracsur.2016.04.017

Cited by 34 publications

(23 citation statements)

References 21 publications

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“…Barili et al reported that mortality incidence was significantly higher in women which were 17.3% compared to 9.8% in men, with a p <0.008. Based on standard deviation, both deceased and living patients had a fairly wide sample variation based on standard deviation, therefore, EuroSCORE II is not always appropriate in assessing mortality risk (14). Table 2 shows that the mean EuroSCORE II for deceased patients was 22.36% with a standard deviation of ± 26.97% while living patients were 6.78% with a standard deviation of ± 6.4%.…”

Section: Resultsmentioning

confidence: 99%

EuroSCORE II as Predictor of Mortality and Morbidity in Post-CABG Patient in Dr. Soetomo General Academic Hospital

Rianda

Semedi

Subagjo

et al. 2022

IJAR

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Introduction: European System for Cardiac Operative Risk Evaluation (EuroSCORE) is a scoring system to predict mortality risk after cardiac surgery. EuroSCORE II was introduced to replace and show superiority over EuroSCORE I which tends to overestimate the risk of heart surgery procedures and have a low discrimination ability. Meanwhile, this is the first study to analyze EuroSCORE II as a predictor of mortality and morbidity in Indonesians. Objective: This study aims to analyze EuroSCORE II as a predictor of mortality and morbidity in Indonesians. Materials and Methods: This is a retrospective study using medical records of CABG patients in Dr. Soetomo General Academic Hospital from January 2016 to December 2017. Results and Discussion: Out of 39 Patients who have performed CABG surgery, most were male (89.7%) with the highest age range of 46-65 years (59%). Deceased patients had an average EuroSCORE II of 22.36% and SD±26.97%7%, while 27 patients who survived had an average EuroSCORE II of 6.78% and SD±6.4%. Based on morbidity assessment, EuroSCORE II only accurately predicted the risk of kidney failure and did not properly assess the length of inotropic use, vasopressors, hospitalization time, the risk of arrhythmias, low cardiac output syndrome, Durante-operative bleeding, and the need for blood transfusion. These inaccuracies occurred because the samples that were included varied based on their standard deviation and pattern-less graph. Conclusion: EuroSCORE II is inadequate to predict morbidity and mortality in postoperative patients, therefore, it is considered less effective.

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Section: Resultsmentioning

confidence: 99%

EuroSCORE II as Predictor of Mortality and Morbidity in Post-CABG Patient in Dr. Soetomo General Academic Hospital

Rianda

Semedi

Subagjo

et al. 2022

IJAR

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“…An important finding in our study is the lack of predictive power of the currently used EuroSCORE II risk model with respect to physical recovery. Specifically designed and calibrated for the prediction of short-term mortality, the predictive power of the EuroSCORE II risk model is known to diminish with respect to 1 and 5 year mortality [ 12 , 13 ]. Notwithstanding the fact that other risk models claim better performance for long-term mortality, the relationship between such risk scores and HRQoL-related endpoints remains largely unexplored [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Determinants of non-recovery in physical health-related quality of life one year after cardiac surgery: a prospective single Centre observational study

Jong

Haenen

Raap

et al. 2020

J Cardiothorac Surg

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Background: Recent studies show that substantial percentage of patients experienced worsening of health related quality of life (HRQoL) 1 year after cardiac surgery. The aim of this study is to identify risk factors that interfere with improvement of HRQoL. Methods: From December 2015 till July 2017 a prospective single centre observational study was carried out in 1920 patients participated who underwent non-salvage cardiac surgery. All patients were requested to complete a Short Form 36 (SF-36) questionnaire before and 1 year after surgery. Primary aim of the study was to identify risk factors for non-recovery in the physical domain of the SF-36 in all cardiac surgery patients. Secondary aim was to identify identical risk factors in patients with isolated coronary artery bypass grafting. Results: After cardiac surgery, the questionnaires for physical and mental health were completed by respectively 803 and 807 patients. Median age was 69[62-75] years, and 77% was male. In comparison to the preoperative status, 176 patients (21.9%) did not display an improvement in the SF-36 physical domain score 1 year after cardiac surgery. In a multivariate analysis independent risk factors for non-recovery in the SF-36 physical domain were baseline SF36 physical domain score (OR 0.954[0.942-0.965], P < 0.001), diabetes (OR 0.437 [0.265-0.720], P 0.001), female sex (OR 0.492 [0.307-0.789], P 0.003), post-operative infection (OR 0.240 [0.109-0.525], P < 0.001) and PCI within 1 year (OR 0.113 [0.036-0.349], P < 0.001) For isolated CABG, 23.2% of patients did not display an improvement in the physical domain score and risk factors appeared to be identical. Conclusions: Twenty two percent of all cardiac surgery patients did not show an improvement in the physical domain score of the HRQoL between the preoperative period and 1 year after surgery. Independent risk factors for non-recovery after cardiac surgery were baseline SF-36 physical domain score, diabetes, female sex, any postoperative infection and the need for PCI in the first year. Further research is needed to tailor the patient selection procedure prior to surgery and potentially modify risk factors in the perioperative process.

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“…The identification of new risk factors for peri- and post-operative mortality is a core issue for guaranteeing high-quality results in risk-scoring systems. Several studies have reported a progressive worsening of the ESII model performances when applied to follow-up longer than 30 days [24]. In particular for isolated CABG surgeries, a poor calibration of ESII, in both the highest and lowest risk-patient groups, was reported [25].…”

Section: Discussionmentioning

confidence: 99%

Aortic Valve Sclerosis Adds to Prediction of Short-Term Mortality in Patients with Documented Coronary Atherosclerosis

Poggio

Cavallotti

Myasoedova

et al. 2019

JCM

Self Cite

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Aims: Aortic valve sclerosis (AVSc), a non-uniform thickening of leaflets with an unrestricted opening, is characterized by inflammation, lipoprotein deposition, and matrix degradation. In the general population, AVSc predicts long-term cardiovascular mortality (+50%) even after adjustment for vascular risk factors and clinical atherosclerosis. We have hypothesized that AVSc is a risk-multiplier able to predict even short-term mortality. To address this issue, we retrospectively analyzed 90-day mortality of all patients who underwent isolated coronary artery bypass grafting (CABG) at Centro Cardiologico Monzino over a ten-year period (2006–2016). Methods: We analyzed 2246 patients and 90-day all-cause mortality was 1.5% (31 deaths). We selected only patients deceased from cardiac causes (n = 29) and compared to alive patients (n = 2215). A cardiologist classified the aortic valve as no-AVSc (n = 1352) or AVSc (n = 892). Cox linear regression and integrated discrimination improvement (IDI) analyses were used to evaluate AVSc in predicting 90-day mortality. Results: AVSc 90-day survival (97.6%) was lower than in no-AVSc (99.4%; p < 0.0001) with a hazard ratio (HR) of 4.0 (95%CI: 1.78, 9.05; p < 0.0001). The HR for AVSc, adjusted for propensity score, was 2.7 (95%CI: 1.17, 6.23; p = 0.02) and IDI statistics confirmed that AVSc significantly adds (p < 0.001) to the identification of high-risk patients than EuroSCORE II alone. Conclusion: Our data supports the hypothesis that a risk stratification strategy based on AVSc, added to ESII, may allow better recognition of patients at high-risk of short-term mortality after isolated surgical myocardial revascularization. Results from this study warrant further confirmation.

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The Impact of EuroSCORE II Risk Factors on Prediction of Long-Term Mortality

Cited by 34 publications

References 21 publications

EuroSCORE II as Predictor of Mortality and Morbidity in Post-CABG Patient in Dr. Soetomo General Academic Hospital

EuroSCORE II as Predictor of Mortality and Morbidity in Post-CABG Patient in Dr. Soetomo General Academic Hospital

Determinants of non-recovery in physical health-related quality of life one year after cardiac surgery: a prospective single Centre observational study

Aortic Valve Sclerosis Adds to Prediction of Short-Term Mortality in Patients with Documented Coronary Atherosclerosis

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