OBJECTIVES: The European System for Cardiac Operative Risk Evaluation (EuroSCORE) has been used for many years since its introduction in 1999. Recently, a new EuroSCORE (EuroSCORE II) has been developed to update the previous version. The EuroSCORE II includes some different predictors and/or introduces a new classification of the already existing predictors. This study presents a validation series for the EuroSCORE II compared with the previous additive and the logistic EuroSCORE and with the Age, Creatinine and Ejection Fraction (ACEF) score. METHODS: A total of 1090 consecutive adult patients operated on at our institution from September 2010 to October 2011 were admitted to this retrospective study. All the patients received a risk stratification based on the EuroSCORE II and the other scores considered. Accuracy, calibration and clinical performance of the various risk models were assessed. RESULTS: The accuracy of the EuroSCORE II was good (c-statistic 0.81) but not significantly higher than the other scores (range 0.78-0.8). Calibration at the Hosmer-Lemeshow statistic was good for all the scores; the difference between observed (3.75%) and predicted mortality in the overall population was not significant for the EuroSCORE II (3.1%) and the ACEF score (3.4%), whereas the additive EuroSCORE (5.8%) and the logistic EuroSCORE (7.3%) significantly overestimated the risk. In patients at low, mild moderate and high mortality risk, the EuroSCORE II provided a risk prediction not significantly different from the observed mortality rate, whereas in very high-risk patients (observed mortality rate 11%), it significantly underestimated (6.5%) the mortality risk. The accuracy of the EuroSCORE II was acceptable in isolated coronary surgery, and good or excellent in the other operations. CONCLUSIONS: The EuroSCORE II represents a useful update of the previous EuroSCORE version, with a much better clinical performance and the same good level of accuracy. It is possible that for the risk stratification of very high-risk patients, other factors (rare but associated with a mortality rate >50%) should be included in the future models.
OBJECTIVES: The European System for Cardiac Operative Risk Evaluation (EuroSCORE) has been used for many years since its introduction in 1999. Recently, a new EuroSCORE (EuroSCORE II) has been developed to update the previous version. The EuroSCORE II includes some different predictors and/or introduces a new classification of the already existing predictors. This study presents a validation series for the EuroSCORE II compared with the previous additive and the logistic EuroSCORE and with the Age, Creatinine and Ejection Fraction (ACEF) score. METHODS: A total of 1090 consecutive adult patients operated on at our institution from September 2010 to October 2011 were admitted to this retrospective study. All the patients received a risk stratification based on the EuroSCORE II and the other scores considered. Accuracy, calibration and clinical performance of the various risk models were assessed. RESULTS: The accuracy of the EuroSCORE II was good (c-statistic 0.81) but not significantly higher than the other scores (range 0.78-0.8). Calibration at the Hosmer-Lemeshow statistic was good for all the scores; the difference between observed (3.75%) and predicted mortality in the overall population was not significant for the EuroSCORE II (3.1%) and the ACEF score (3.4%), whereas the additive EuroSCORE (5.8%) and the logistic EuroSCORE (7.3%) significantly overestimated the risk. In patients at low, mild moderate and high mortality risk, the EuroSCORE II provided a risk prediction not significantly different from the observed mortality rate, whereas in very high-risk patients (observed mortality rate 11%), it significantly underestimated (6.5%) the mortality risk. The accuracy of the EuroSCORE II was acceptable in isolated coronary surgery, and good or excellent in the other operations. CONCLUSIONS: The EuroSCORE II represents a useful update of the previous EuroSCORE version, with a much better clinical performance and the same good level of accuracy. It is possible that for the risk stratification of very high-risk patients, other factors (rare but associated with a mortality rate >50%) should be included in the future models.
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: Georg Heinze; Torsten Christ; Christopher O Leonards; Pascal M Dohmen; Wolfgang Konertz Journal: Ann Thorac Cardiovasc Surg Date: 2015-05-25 Impact factor: 1.520
Authors: Carey Kimmelstiel; David C Zisa; Johny S Kuttab; Sophie Wells; James E Udelson; Benjamin S Wessler; Hassan Rastegar; Navin K Kapur; Andrew R Weintraub; Barry J Maron; Martin S Maron; Ethan J Rowin Journal: Circ Cardiovasc Interv Date: 2019-07-12 Impact factor: 6.546
Authors: Marco Ranucci; Umberto Di Dedda; Serenella Castelvecchio; Maria Teresa La Rovere; Lorenzo Menicanti Journal: J Cardiothorac Surg Date: 2016-01-19 Impact factor: 1.637
Authors: Sophie Provenchère; Arnaud Chevalier; Walid Ghodbane; Claire Bouleti; Philippe Montravers; Dan Longrois; Bernard Iung Journal: PLoS One Date: 2017-11-16 Impact factor: 3.240