Validation of EuroSCORE II on a single-centre 3800 patient cohort

Abstract

OBJECTIVES: To compare and validate the new European System for Cardiac Operative Risk Evaluation (EuroSCORE) II with EuroSCORE at our institution. METHODS: The logistic EuroSCORE and EuroSCORE II were calculated on the entire patient cohort undergoing major cardiac surgery at our centre between January 2005 and December 2010. The goodness of fit was compared by means of the Hosmer-Lemeshow (HL) chi-squared test and the area under the curve (AUC) of the receiver operating characteristic curves of both scales applied to the same sample of patients. These analyses were repeated and stratified by the type of surgery. RESULTS: Mortality of 5.66% was observed, with estimated mortalities according to logistic EuroSCORE and EuroSCORE II of 9 and 4.46%, respectively. The AUC for EuroSCORE (0.82, 95% confidence interval [CI] 0.79-0.85) was lower than that for EuroSCORE II (0.85, 95% CI 0.83-0.87) without the differences being statistically significant (P = 0.056). Both scales showed a good discriminative capacity for all the pathologies subgroups. The two scales showed poor calibration in the sample: EuroSCORE (χ 2 = 39.3, P HL < 0.001) and EuroSCORE II (χ 2 = 86.69, P HL < 0.001). The calibration of EuroSCORE was poor in the groups of patients undergoing coronary (P HL = 0.01), valve (P HL = 0.01) and combined coronary valve surgery (P HL = 0.012); and that of EuroSCORE II in the group of coronary (P HL = 0.001) and valve surgery (P HL < 0.001) patients. CONCLUSIONS: EuroSCORE II demonstrated good discriminative capacity and poor calibration in the patients undergoing major cardiac surgery at our centre.

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

“…The mortality rate in our study was at the level of 5.21% and it did not differ with the background of other similar studies, in which this value ranged from 2.2% to 5.66% [8][9][10][11][12][13]. For our CABG patients, this value was 5.33%.…”

“…As shown in Table 3, all examined predicting models had RAMR above 1.0 and overestimated the predicted mortality for the entire cohort as well as for CABG-patients. Carnero-Alcazar et al [10] observed similarly that for a global group, ESII overestimated postoperative mortality risk (RAMR: 1.27) and slightly underestimated it in the case of coronary patients (RAMR: 0.94). It was also proven that among these two groups of patients, logES also underestimated mortality [10].…”

The application of European system for cardiac operative risk evaluation II (EuroSCORE II) and Society of Thoracic Surgeons (STS) risk-score for risk stratification in Indian patients undergoing cardiac surgery

“…Both the scores accurately predicted mortality in low and moderate risk patients, but over-estimated the risk in high risk category as shown in Tables 3 and 4. [5,6] Spain, [7] Italy [8,9] and Finland. [10] These validation studies demonstrated that EuroSCORE II is a good predictor of perioperative mortality and performs better over previous versions.…”

Expected and Observed Mortality in Patients Undergoing Coronary Artery Bypass Surgery

“…19 Carnero-Alcazar ve ark.nın çalışmasında da koroner arter baypas operasyonu olanlarda göz-lenen mortalite (%3,09) beklenen mortaliteden (%3,28) düşük bulunmakla birlikte bu farklılığın istatistiksel olarak anlamlı olmadığı bildirilmiştir. 20 Chalmers ve ark.nın çalışmasında da koroner baypas operasyonlarında gözlenen mortalite %1,9 beklenen mortalite ise %1,7 (%1,1-3,3) bulunmuş olup bu değerler istatistiksel olarak benzerdir. pas operasyonlarında gözlenen mortalite %1,9 (%0-3,8) olup beklenen mortaliteden düşüktür (%2,1; 0,60-0,98), fakat bu fark istatistiksel olarak anlamlı bulunmamıştır.…”