Literature DB >> 20078709

EuroSCORE predicts short- and mid-term mortality in combined aortic valve replacement and coronary artery bypass patients.

Kimiyoshi J Kobayashi1, Jason A Williams, Lois U Nwakanma, Eric S Weiss, Vincent L Gott, William A Baumgartner, John V Conte.   

Abstract

BACKGROUND AND AIM OF THE STUDY: European system for cardiac operative risk evaluation (EuroSCORE) has been studied for its effectiveness in predicting operative mortality, and more recently, long-term mortality in a wide variety of cardiac surgical procedures. Combined coronary artery bypass and aortic valve replacement (AVR-CABG) carries increased perioperative risk, and tends to have higher-risk patients. Performance of the EuroSCORE system in patients undergoing concomitant AVR-CABG has not been well established. Thus, we aimed to analyze the accuracy of both additive and logistic EuroSCOREs in predicting operative and mid-term mortality.
METHODS: We retrospectively reviewed and calculated EuroSCOREs for all patients who underwent AVR-CABG between January 2000 and December 2004. Patients who had previous cardiac surgery and those undergoing any concomitant procedures were excluded. Areas under the receiver operator curves (ROC) were determined to assess EuroSCORE's accuracy in predicting operative mortality. Kaplan-Meier analysis and Cox regression were used to determine mid-term survival, freedom from repeat revascularization, and predictors of these outcomes.
RESULTS: There were 233 patients who met study criteria. Mean follow-up period was 2.2 +/- 1.7 years with one patient lost to follow-up. Mean additive and logistic EuroSCOREs were 8.77 and 16.1, respectively, with an observed mortality of 9.44%. The area under the ROC curves for additive EuroSCORE was 0.76 and for logistic EuroSCORE was 0.75. Regression analysis revealed additive EuroSCORE, but not logistic EuroSCORE, to be predictive of mid-term mortality.
CONCLUSIONS: Both additive and logistic EuroSCOREs were accurate in predicting operative morality. Only additive EuroSCORE was predictive of mid-term mortality in AVR-CABG patients. EuroSCORE remains a good and well-validated risk stratification model applicable to patients who undergo concomitant AVR-CABG.

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Year:  2009        PMID: 20078709     DOI: 10.1111/j.1540-8191.2009.00906.x

Source DB:  PubMed          Journal:  J Card Surg        ISSN: 0886-0440            Impact factor:   1.620


  12 in total

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Journal:  J Cardiothorac Surg       Date:  2012-04-11       Impact factor: 1.637

6.  Operative treatment of combined aortic stenosis and coronary artery disease.

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7.  Depression, anxiety and major adverse cardiovascular and cerebrovascular events in patients following coronary artery bypass graft surgery: a five year longitudinal cohort study.

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8.  30-day mortality after coronary artery bypass grafting and valve surgery has greatly improved over the last decade, but the 1-year mortality remains constant.

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Journal:  Ann Card Anaesth       Date:  2015 Apr-Jun

9.  Plasma concentrations predict aortic expression of growth-arrest-specific protein 6 in patients undergoing coronary artery bypass grafting.

Authors:  Chien-Hsing Lee; Yi-Shing Shieh; Chien-Sung Tsai; Yi-Jen Hung; Yi-Ting Tsai; Chih-Yuan Lin
Journal:  PLoS One       Date:  2013-11-13       Impact factor: 3.240

10.  Prognosis after surgical replacement with a bioprosthetic aortic valve in patients with severe symptomatic aortic stenosis: systematic review of observational studies.

Authors:  Farid Foroutan; Gordon H Guyatt; Kathleen O'Brien; Eva Bain; Madeleine Stein; Sai Bhagra; Daegan Sit; Rakhshan Kamran; Yaping Chang; Tahira Devji; Hassan Mir; Veena Manja; Toni Schofield; Reed A Siemieniuk; Thomas Agoritsas; Rodrigo Bagur; Catherine M Otto; Per O Vandvik
Journal:  BMJ       Date:  2016-09-28
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