BACKGROUND: We compare two widely used risk algorithms for coronary bypass surgery: The European System for Cardiac Operative Risk Evaluation (EuroSCORE) and The Society of Thoracic Surgeons (STS) risk stratification algorithm. METHODS: Risk factors for all adult patients undergoing heart surgery at the University Hospital of Lund between 1996 and 2001 were collected prospectively at preoperative admission. Predictive accuracy for 30-day mortality was assessed by comparing the observed and the expected mortality for equal-sized quintiles of risk by using the Hosmer-Lemeshow goodness-of-fit test. The discriminatory power was evaluated by calculating the areas under receiver operating characteristics (ROC) curves. RESULTS: The study included 4497 coronary artery bypass-only operations. The average age was 66.4 +/- 9.3 years (range 31 to 90 years). Most patients were men (77.0% versus 23.0%). The actual 30-day mortality was 1.89%. The Hosmer-Lemeshow goodness-of-fit test gave a p value of 0.81 (EuroSCORE) and 0.83 (STS), which indicates a good accuracy of both models. The area under the ROC curve was 0.84 (95% confidence interval [CI] 0.80 to 0.88) for EuroSCORE and 0.71 (95% CI 0.66 to 0.77) for STS. The discriminatory power (area under the ROC curve) was significantly larger for EuroSCORE compared with STS (p < 0.00005). CONCLUSIONS: In this large, single institution study the additive EuroSCORE algorithm had a significantly better discriminatory power to predict 30-day mortality than the STS risk algorithm for patients undergoing coronary artery bypass.
BACKGROUND: We compare two widely used risk algorithms for coronary bypass surgery: The European System for Cardiac Operative Risk Evaluation (EuroSCORE) and The Society of Thoracic Surgeons (STS) risk stratification algorithm. METHODS: Risk factors for all adult patients undergoing heart surgery at the University Hospital of Lund between 1996 and 2001 were collected prospectively at preoperative admission. Predictive accuracy for 30-day mortality was assessed by comparing the observed and the expected mortality for equal-sized quintiles of risk by using the Hosmer-Lemeshow goodness-of-fit test. The discriminatory power was evaluated by calculating the areas under receiver operating characteristics (ROC) curves. RESULTS: The study included 4497 coronary artery bypass-only operations. The average age was 66.4 +/- 9.3 years (range 31 to 90 years). Most patients were men (77.0% versus 23.0%). The actual 30-day mortality was 1.89%. The Hosmer-Lemeshow goodness-of-fit test gave a p value of 0.81 (EuroSCORE) and 0.83 (STS), which indicates a good accuracy of both models. The area under the ROC curve was 0.84 (95% confidence interval [CI] 0.80 to 0.88) for EuroSCORE and 0.71 (95% CI 0.66 to 0.77) for STS. The discriminatory power (area under the ROC curve) was significantly larger for EuroSCORE compared with STS (p < 0.00005). CONCLUSIONS: In this large, single institution study the additive EuroSCORE algorithm had a significantly better discriminatory power to predict 30-day mortality than the STS risk algorithm for patients undergoing coronary artery bypass.
Authors: Nadia Bouabdallaoui; Susanna R Stevens; Torsten Doenst; Mark C Petrie; Nawwar Al-Attar; Imtiaz S Ali; Andrew P Ambrosy; Anna K Barton; Raymond Cartier; Alexander Cherniavsky; Pierre Demondion; Patrice Desvigne-Nickens; Robert R Favaloro; Sinisa Gradinac; Petra Heinisch; Anil Jain; Marek Jasinski; Jerome Jouan; Renato A K Kalil; Lorenzo Menicanti; Robert E Michler; Vivek Rao; Peter K Smith; Marian Zembala; Eric J Velazquez; Hussein R Al-Khalidi; Jean L Rouleau Journal: Circ Heart Fail Date: 2018-11 Impact factor: 8.790
Authors: Jarrod E Dalton; David A Zidar; Belinda L Udeh; Manesh R Patel; Jesse D Schold; Neal V Dawson Journal: Med Care Date: 2016-06 Impact factor: 2.983
Authors: Teresa S Henriques; Madalena D Costa; Pooja Mathur; Priyam Mathur; Roger B Davis; Murray A Mittleman; Kamal R Khabbaz; Ary L Goldberger; Balachundhar Subramaniam Journal: J Clin Monit Comput Date: 2018-03-21 Impact factor: 2.502
Authors: David R Lawrence; Rajael Somaskanthan; Matthew J Barnard; Miles Curtis; Bruce E Keogh Journal: Ann R Coll Surg Engl Date: 2009-04-02 Impact factor: 1.891