Original articlePredictive Value of the Additive and Logistic EuroSCOREs in Patients Undergoing Aortic Valve Replacement
Section snippets
Methods
All patients undergoing isolated AVR and AVR with CABG surgery between January 2004 and December 2010 at the authors' institution were included in this study. The data were collected prospectively and retrospectively analyzed. This study was approved by the local Medical-Ethical Review Committee, which waived the need for informed consent. Patients were divided into 2 groups: patients who underwent isolated AVR and patients who underwent combined AVR with CABG surgery. Patients who had active
Results
During a 7-year period (January 2004 until December 2010), 1,072 patients underwent isolated AVR, and 813 patients underwent combined AVR with CABG surgery at this institution. The basic characteristics and operative data are summarized in Table 1. Patients in the AVR with CABG surgery group were significantly older and were significantly less often male. Moreover, patients in the AVR with CABG surgery group more often had diabetes, hypertension, peripheral vascular disease, and a left
Discussion
The main finding of this study was that both the additive and the logistic EuroSCOREs overestimated the operative mortality in low-risk patients undergoing AVR with or without CABG surgery. Similar results were published by van Gameren et al.5 In their study, the logistic EuroSCORE predicted a mortality of 6.1%, and the additive EuroSCORE predicted a mortality of 5.3% for patients undergoing an isolated AVR. However, the observed mortality was 2.8%. For patients with combined AVR and CABG
Conclusion
Although both additive and logistic EuroSCOREs could discriminate well between operative deaths and survivors, they were not accurate predictors of the actual operative mortality of patients undergoing isolated AVR or AVR with CABG surgery at the authors' institution. In fact, both EuroSCOREs overestimated the operative risk in low-risk patients. A risk scoring system dedicated to aortic valve surgery based on more contemporary results is warranted.
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Meta-analysis on the performance of the EuroSCORE II and the society of thoracic surgeons scores in patients undergoing aortic valve replacement
2014, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :This pooled analysis showed that current O/E mortality ratios estimated by either the ESII score or the STS score approached 1.0 in patients undergoing aortic valve replacement. This is a remarkable improvement particularly for the ESII score, as the logistic EuroSCORE was shown to significantly and markedly overpredict the operative risk.17 In fact, the O/E mortality ratio estimated by the logistic EuroSCORE in patients undergoing aortic valve surgery with or without coronary surgery was shown to range from 0.45 to 0.56 in the meta-analysis by Parolari et al18 and from 0.32 to 0.61 in the meta-analysis by Siregar et al.19 This excessive overprediction of the logistic EuroSCORE currently prevents its clinical use.20
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