Περίληψη:
Background. The European System for Cardiac Operative Risk Evaluation
(EuroSCORE) is the most rigorously evaluated scoring system in cardiac
surgery. We sought to evaluate the performance of EuroSCORE in the
prediction of long-term mortality in patients undergoing heart valve
surgery.
Methods. Medical records of patients with isolated or combined heart
valve surgery, who were discharged alive (n = 1035), were
retrospectively reviewed. Their operative surgical risks were calculated
according to EuroSCORE model (standard and logistic). Long-term survival
data (mean follow-up 4.5 +/- 3.1 years) were obtained from the National
Death Index. Kaplan-Meier curves of the quartiles of standard and
logistic EuroSCORE were plotted.
Results. The estimated 5-year survival rates of the quartiles in the
standard and logistic EuroSCORE model were: 90.0% +/- 2.3%, 85.1% +/-
2.3%, 64.8% +/- 3.3%, and 55.1% +/- 3.7% (p < 0.0001, log-rank test
with adjustment for trend) and 90.4% +/- 2.2%, 86.4% +/- 2.5%,
66.9% +/- 3.3%, and 56.1% +/- 3.3% (p < 0.0001, log-rank test with
adjustment for trend) respectively. The odds of death in the
highest-risk quartile were 7.46- and 7.82-fold higher than the odds of
death in the lowest-risk quartile for standard and logistic EuroSCORE
respectively.
Conclusions. EuroSCORE can be used to predict not only in-hospital
mortality, for which it was originally designed, but also long-term
mortality in the whole context of heart valve surgery. This outcome can
be predicted using the standard EuroSCORE, which is very simple and easy
in its calculation. (c) 2005 by The Society of Thoracic Surgeons.
Συγγραφείς:
Toumpoulis, IK
Anagnostopoulos, CE
Toumpoulis, SK
DeRose, JJ
and Swistel, DG
