open access

Vol 74, No 5 (2016)
Original articles
Published online: 2015-11-12
Submitted: 2015-03-20
Accepted: 2015-09-22
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EuroSCORE II does not show better accuracy nor predictive power in comparison to original EuroSCORE: a single-centre study

Kamil Janikowski, Robert Morawiec, Bogdan Jegier, Ryszard Jaszewski, Małgorzata Lelonek
DOI: 10.5603/KP.a2015.0215
·
Pubmed: 26575309
·
Kardiol Pol 2016;74(5):469-475.

open access

Vol 74, No 5 (2016)
Original articles
Published online: 2015-11-12
Submitted: 2015-03-20
Accepted: 2015-09-22

Abstract

Background: EuroSCORE is used to predict postoperative mortality in patients undergoing cardiac surgery. Its updated version was published in 2011.

Aim: To assess whether EuroSCORE II (ESII) predicts more accurately postoperative mortality after cardiac surgery in comparison with additive (addES) and logistic EuroSCORE (logES).

Methods: A total of 461 patients (aged 21–88 years, 63.4% of men) who underwent cardiac surgery (December 2010 – June 2011) were included into the prospective research. For each patient ESII, addES and logES were calculated. Accuracy, calibration, and clinical performance of these models were assessed with receiver operating characteristics analyses using the area under the curve and the Hosmer-Lemeshow test. Out of this population, a group of 300 coronary artery bypass grafting (CABG) patients (aged 42–85 years, 73% of men) was selected and statistically analysed using the same methods.

Results: The mortality rate was 5.21%. Predicted mortality rates were as follows: addES 4.68%, logES 4.57%, and ESII 1.89%; the accuracy was: 0.589, 0.728, and 0.726, respectively. Only logES presented good predictive power (Hosmer-Lemeshow test: c2 = 12.79, p = 0.12). In the CABG patients, the postoperative mortality rate was 5.33%. Predicted mortality rates were as follows: addES 4.69%, logES 4.59%, and ESII 1.88%; the accuracy was: 0.512, 0.691, and 0.687, respectively. In the Hosmer-Lemeshow test also logES presented good predictive power (c2 = 10.72, p = 0.218).

Conclusions: EuroSCORE II did not estimate mortality risk better in comparison to its previous versions, in the entire studied population or in the CABG patients. On the basis of the analysed data, it seems that the closest to the actual risk of death for the Polish population is the EuroSCORE logistic model.

Abstract

Background: EuroSCORE is used to predict postoperative mortality in patients undergoing cardiac surgery. Its updated version was published in 2011.

Aim: To assess whether EuroSCORE II (ESII) predicts more accurately postoperative mortality after cardiac surgery in comparison with additive (addES) and logistic EuroSCORE (logES).

Methods: A total of 461 patients (aged 21–88 years, 63.4% of men) who underwent cardiac surgery (December 2010 – June 2011) were included into the prospective research. For each patient ESII, addES and logES were calculated. Accuracy, calibration, and clinical performance of these models were assessed with receiver operating characteristics analyses using the area under the curve and the Hosmer-Lemeshow test. Out of this population, a group of 300 coronary artery bypass grafting (CABG) patients (aged 42–85 years, 73% of men) was selected and statistically analysed using the same methods.

Results: The mortality rate was 5.21%. Predicted mortality rates were as follows: addES 4.68%, logES 4.57%, and ESII 1.89%; the accuracy was: 0.589, 0.728, and 0.726, respectively. Only logES presented good predictive power (Hosmer-Lemeshow test: c2 = 12.79, p = 0.12). In the CABG patients, the postoperative mortality rate was 5.33%. Predicted mortality rates were as follows: addES 4.69%, logES 4.59%, and ESII 1.88%; the accuracy was: 0.512, 0.691, and 0.687, respectively. In the Hosmer-Lemeshow test also logES presented good predictive power (c2 = 10.72, p = 0.218).

Conclusions: EuroSCORE II did not estimate mortality risk better in comparison to its previous versions, in the entire studied population or in the CABG patients. On the basis of the analysed data, it seems that the closest to the actual risk of death for the Polish population is the EuroSCORE logistic model.

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Keywords

cardiac surgery, EuroSCORE, mortality, risk stratification

About this article
Title

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

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 74, No 5 (2016)

Pages

469-475

Published online

2015-11-12

DOI

10.5603/KP.a2015.0215

Pubmed

26575309

Bibliographic record

Kardiol Pol 2016;74(5):469-475.

Keywords

cardiac surgery
EuroSCORE
mortality
risk stratification

Authors

Kamil Janikowski
Robert Morawiec
Bogdan Jegier
Ryszard Jaszewski
Małgorzata Lelonek

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