Περίληψη:
Background: To evaluate the performance of EuroSCORE in the prediction
of in-hospital postoperative length of stay and specific major
postoperative complications after coronary artery bypass grafting
(CABG).
Methods: Data on 3760 consecutive patients with CABG were prospectively
collected. The EuroSCORE model (standard and logistic) was used to
predict in-hospital mortality, prolonged length of stay (> 12 days) and
major postoperative complications (stroke, myocardial infarction,
sternal infection, bleeding, sepsis and/or endocarditis,
gastrointestinal complications, renal and respiratory failure). A C
statistic (receiver operating characteristic curve) was used to test the
discrimination of the EuroSCORE. The calibration of the model was
assessed by the Hosmer-Lemeshow goodness-of-fit statistic.
Results: In-hospital mortality was 2.7%, and 13.7% of patients had one
or more major complications. EuroSCORE showed very good discriminatory
ability in predicting renal failure (C statistic: 0.80) and good
discriminatory ability in predicting in-hospital mortality (C statistic:
0.75), sepsis and/or endocarditis (C statistic: 0.72) and prolonged
length of stay (C statistic: 0.71). There were no differences in terms
of the discriminatory ability between standard and logistic EuroSCORE.
Standard EuroSCORE showed good calibration (Hosmer-Lemeshow: P>0.05) in
predicting these outcomes except for postoperative length of stay, while
logistic EuroSCORE showed good calibration only in predicting renal
failure.
Conclusions: EuroSCORE can be used to predict not only in-hospital
mortality, for which it was originally designed, but also prolonged
length of stay and specific postoperative complications such as renal
failure and sepsis and/or endocarditis after CABG. These outcomes can be
predicted accurately using the standard EuroSCORE which is very simple
and easy in its calculation. (c) 2005 Elsevier Ireland Ltd. All rights
reserved.
Συγγραφείς:
Toumpoulis, IK
Anagnostopoulos, CE
DeRose, JJ
Swistel, DG
