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      Comparison of original EuroSCORE, EuroSCORE II and STS risk models in a Turkish cardiac surgical cohort

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      Author
      Kunt, A.G.
      Kurtcephe, M.
      Hidiroglu, M.
      Cetin L.
      Kucuker, A.
      Bakuy V.
      Ruchan Akar, A.
      Sener, E.
      Date
      2013
      Source Title
      Interactive Cardiovascular and Thoracic Surgery
      Print ISSN
      15699293
      Volume
      16
      Issue
      5
      Pages
      625 - 629
      Language
      English
      Type
      Article
      Item Usage Stats
      152
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      81
      downloads
      Abstract
      OBJECTIVESThe aim of this study was to compare additive and logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE), EuroSCORE II and the Society of Thoracic Surgeons (STS) models in calculating mortality risk in a Turkish cardiac surgical population.METHODSThe current patient population consisted of 428 patients who underwent isolated coronary artery bypass grafting (CABG) between 2004 and 2012, extracted from the TurkoSCORE database. Observed and predicted mortalities were compared for the additive/logistic EuroSCORE, EuroSCORE II and STS risk calculator. The area under the receiver operating characteristics curve (AUC) values were calculated for these models to compare predictive power.RESULTSThe mean patient age was 74.5 ± 3.9 years at the time of surgery, and 35.0% were female. For the entire cohort, actual hospital mortality was 7.9% (n = 34; 95% confidence interval [CI] 5.4-10.5). However, the additive EuroSCORE-predicted mortality was 6.4% (P = 0.23 vs observed; 95% CI 6.2-6.6), logistic EuroSCORE-predicted mortality was 7.9% (P = 0.98 vs observed; 95% CI 7.3-8.6), EuroSCORE II- predicted mortality was 1.7% (P = 0.00 vs observed; 95% CI 1.6-1.8) and STS predicted mortality was 5.8% (P = 0.10 vs observed; 95% CI 5.4-6.2). The mean predictive performance of the analysed models for the entire cohort was fair, with 0.7 (95% CI 0.60-0.79). AUC values for additive EuroSCORE, logistic EuroSCORE, EuroSCORE II and STS risk calculator were 0.70 (95% CI 0.60-0.79), 0.70 (95% CI 0.59-0.80), 0.72 (95% CI 0.62-0.81) and 0.62 (95% CI 0.51-0.73), respectively.CONCLUSIONSEuroSCORE II significantly underestimated mortality risk for Turkish cardiac patients, whereas additive and logistic EuroSCORE and STS risk calculators were well calibrated. © 2013 The Author 2013.
      Keywords
      Coronary artery bypass grafting
      EuroSCORE
      Mortality
      Risk prediction model
      Society of Thoracic Surgeons risk calculator
      aged
      article
      cardiovascular mortality
      clinical practice
      cohort analysis
      controlled study
      coronary artery bypass graft
      EuroSCORE
      EuroSCORE II
      female
      human
      intermethod comparison
      major clinical study
      male
      outcome assessment
      population research
      priority journal
      prospective study
      rating scale
      receiver operating characteristic
      risk assessment
      Society of Thoracic Surgeons model
      Aged
      Algorithms
      Area Under Curve
      Coronary Artery Bypass
      Decision Support Techniques
      Female
      Humans
      Logistic Models
      Male
      Reproducibility of Results
      Risk Assessment
      Risk Factors
      ROC Curve
      Time Factors
      Treatment Outcome
      Turkey
      Permalink
      http://hdl.handle.net/11693/20985
      Published Version (Please cite this version)
      http://dx.doi.org/10.1093/icvts/ivt022
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      • Department of Computer Engineering 1368
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