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Netherlands Heart Journal

, Volume 20, Issue 12, pp 494–498 | Cite as

Cardiac operative risk evaluation: The EuroSCORE II, does it make a real difference?

  • L. NoyezEmail author
  • P. C. Kievit
  • H. A. van Swieten
  • M.-J. de Boer
Original Article

Abstract

Background

The EuroSCORE, worldwide used as a model for prediction of mortality after cardiac surgery, has recently been renewed. Since October 2011, the EuroSCORE II calculator is available at the EuroSCORE website and recommended for clinical use. The intention of this paper is to compare the use of the initial EuroSCORE and EuroSCORE II as a risk evaluation tool.

Methods

100 consecutive patients who underwent combined mitral valve and coronary bypass surgery (MVR + CABG) and 100 consecutive patients undergoing combined aortic valve surgery and coronary bypass surgery (AVR + CABG) at the Radboud University Nijmegen Medical Center before 10 October 2011 were included. For both groups the initial EuroSCORE and the EuroSCORE II model were used for risk calculation and based on the calculated risks, cumulative sum charts (CUSUM) were constructed to evaluate the impact on performance monitoring.

Results

For the MVR + CABG group the calculated risk using the initial logistic EuroSCORE was 9.95 ± 8.47 (1.51–45.37) versus 5.08 ± 4.03 (0.67–19.76) for the EuroSCORE II. For the AVR + CABG group 9.50 ± 8.6 (1.51–69.5) versus 4.77 ± 6.6 (0.96–64.24), respectively. For both groups the calculated risk by the EuroSCORE II was statistically lower compared with the initial EuroSCORE (p < 0.001). This lower expected risk has influence on performance monitoring, using risk-adjusted CUSUM analysis.

Conclusion

The EuroSCORE II, based on a recently updated database, reduces the overestimation of the calculated risk by the initial EuroSCORE. This difference is statistically significant and the EuroSCORE II may also reflect better current surgical performance.

Keywords

EuroSCORE EuroSCORE II Operative risk Mitral valve surgery Aortic valve surgery Myocardial revascularization 

References

  1. 1.
    Nashef SA, Roques F, Sharples LD, et al. EuroSCORE II. Eur J Cardiothorac Surg. 2012;41:734–45.PubMedCrossRefGoogle Scholar
  2. 2.
    Nashef SAM, Roques F, Michel P, et al. European system for cardiac preoperative risk evaluation (EuroSCORE). Eur J Cardiothorac Surg. 1999;16:9–13.PubMedCrossRefGoogle Scholar
  3. 3.
    Parolari A, Pesce LL, Trezzi M, et al. EuroSCORE performance in valve surgery: a meta-analysis. Ann Thorac Surg. 2010;89(3):787–93.PubMedCrossRefGoogle Scholar
  4. 4.
    Basraon J, Chandrashekhar YS, John R, et al. Comparison of risk scores to estimate periopertive mortality in aortic valve replacement surgery. Ann Thorac Surg. 2011;92(2):535–40.PubMedCrossRefGoogle Scholar
  5. 5.
    Noyez L. Control charts, CUSUM techniques and funnel plots. A review of methods for monitoring performance in healthcare. Interact Cardiovasc Thorac Surg. 2009;9:494–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Vahanian A, Alfieri O, Al-Attor N, et al. Transcather valve implantation for patients with aortic stenosis: a position statement from the European Association of Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC), in collaboration with the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J. 2008;29:1463–70.PubMedCrossRefGoogle Scholar
  7. 7.
    Wouters CW, Noyez L. Is no news good news? Organized follow-up, an absolute necessity for the evaluation of myocardial revascularization. Eur J Cardiothorac Surg. 2004;26:667–70.PubMedCrossRefGoogle Scholar
  8. 8.
    Steyerberg EW, Eijkemans MJ, Harrel FE, et al. Prognostic modeling with logistic regression analysis: a comparison of selection and estimation methods in small data sets. Stat Med. 2000;19:1059–79.PubMedCrossRefGoogle Scholar
  9. 9.
    Noyez L, Kievit PC, Verkroost MWA, et al. Evaluation of quality in adult cardiac surgery: let us speak the same language. Neth Heart J. 2010;18:365–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Baan J, Yong ZY, Koch KT, et al. Percutaneous implantation of the CoreValve aortic valve prosthesis in patients at high risk or rejected for surgical valve replacement. Neth Heart J. 2010;18:16–24.Google Scholar

Copyright information

© Springer Media / Bohn Stafleu van Loghum 2012

Authors and Affiliations

  • L. Noyez
    • 1
    Email author
  • P. C. Kievit
    • 2
  • H. A. van Swieten
    • 1
  • M.-J. de Boer
    • 2
  1. 1.Department of Cardio-Thoracic Surgery – 677Heart Center, Radboud University Nijmegen Medical CenterNijmegenthe Netherlands
  2. 2.Department of Cardiology -670Radboud University Nijmegen Medical CenterNijmegenthe Netherlands

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