Abstract
Objective: The purpose of this study was to evaluate the usefulness of EuroSCORE in terms of
prediction of the outcome as a result of preoperative information in a cohort of patients.
Methods: We analyzed the data from 751 patients treated between Jan 1 and Dec 31,
1998. We used contingency tables and applied methods of discriminant analysis for
the evaluation. Results: Compared to the 14.799 patients from whose data the EuroSCORE system had originally
been derived [1,2], we had a smaller portion of patients in the low-risk group (24.5
% vs. 30.6 %), a comparable portion of patients in the medium-risk group (42.2 % vs.
40.5 %) and a higher proportion of patients in the high-risk group (33.2 % vs. 29.0
%). This difference in the risk distributions was highly significant (p < 0.001).
The application of the EuroSCORE system showed that deaths only occurred in the high-risk
group in our hospital. We had 36 deaths amongst the patients, which gives an overall
mortality rate of 4.9 % and a mortality rate of 1.6 % in the medium-risk group and
of 12.4 % in the high-risk group. The discriminant analysis showed that with the EuroSCORE
as single predicting variable - virtually all survivors were classified correctly
(giving a specificity of 99.0 %). The sensitivity was rather low at only 25 %; however,
this means that many of the high-risk patients in our clinic survived. The total misclassification
rate, however, was 12.7 %. Additionally, we found that a higher score value predicts
a significantly higher probability for perioperative complications and also results
in significantly increased average times for the bypass and total time for surgery.
Conclusion: The EuroSCORE is a valuable score system for the prediction of the overall outcome
of patients following open heart surgery, and is easy to use. As far as perioperative
complications are concerned, however, some specifications seem desirable.
Key words
Cardiac surgery - risk stratification - mortality - outcome
References
