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

Kunt, A.G.
Kurtcephe, M.
Hidiroglu, M.
Cetin L.
Kucuker, A.
Bakuy V.
Ruchan Akar, A.
Sener, E.
Source Title
Interactive Cardiovascular and Thoracic Surgery
Print ISSN
Electronic ISSN
625 - 629
Journal Title
Journal ISSN
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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.

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Book Title
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
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