Performance of EuroSCORE in CABG and Off-pump Coronary Artery Bypass Grafting: Single Institution Experience and Meta-analysis

Overview

Journal Eur Heart J

Publisher Oxford University Press

Specialty Cardiology & Vascular Diseases

Date 2009 Jan 15

PMID 19141560

Citations 14

Authors

Alessandro Parolari

Lorenzo L Pesce

Matteo Trezzi

Claudia Loardi

Samer Kassem

Claudio Brambillasca

Bruno Miguel

Elena Tremoli

Paolo Biglioli

Francesco Alamanni

Affiliations

Soon will be listed here.

Abstract

Aims: To assess EuroSCORE performance in predicting in-hospital mortality in on-pump coronary artery bypass grafting (CABG) and off-pump coronary artery bypass grafting (OPCAB).

Methods And Results: Additive and logistic EuroSCORE were computed for consecutive patients undergoing CABG (n = 3440, 75%) or OPCAB (n = 1140, 25%) at our hospital from 1999 to September 2007. The areas under the receiver operating characteristic (ROC) curves (AUCs) were used to describe performance and accuracy. No difference in performance between CABG and OPCAB and between additive and logistic EuroSCORE (additive EuroSCORE AUCs of 0.808 and 0.779 for CABG and OPCAB, respectively; logistic EuroSCORE AUCs of 0.813 and of 0.773 for CABG and OPCAB, respectively) was found, although a marked tendency to overpredict mortality by both models was evident. A meta-analysis of previously published data was done, and a total of eight studies representing 19 212 and 5461 patients undergoing CABG and OPCAB, respectively, met inclusion criteria. Meta-analysis confirmed similar performance of EuroSCORE in CABG and OPCAB: estimated AUCs were 0.767 and 0.766 for CABG and OPCAB, respectively, with an estimated difference of 0.001 (95% CI -0.061 to 0.063).

Conclusion: Additive and logistic EuroSCORE algorithms performed similarly, and cumulative evidence suggests comparable performance in CABG and OPCAB procedures; both risk models, however, significantly overestimated mortality.

Citing Articles

Evolution of the Percutaneous Coronary Intervention (PCI) and Coronary Artery Bypass Grafting (CABG) Indication and Mortality Rates in Spain from 2010 to 2019.

Gasulla O, Sarria-Santamera A, Mazaira-Font F, Garcia-Montero C, Fraile-Martinez O, Cantalapiedra D J Cardiovasc Dev Dis. 2024; 11(11).

PMID: 39590212 PMC: 11594947. DOI: 10.3390/jcdd11110369.

Off-pump or on-pump coronary artery bypass at 30 days: A propensity matched analysis.

Wang C, Jiang Y, Song Y, Wang Q, Tian R, Wang D Front Cardiovasc Med. 2022; 9:965648.

PMID: 35979017 PMC: 9376244. DOI: 10.3389/fcvm.2022.965648.

Neutrophil Counts, Neutrophil-to-Lymphocyte Ratio, and Systemic Inflammatory Response Index (SIRI) Predict Mortality after Off-Pump Coronary Artery Bypass Surgery.

Urbanowicz T, Michalak M, Olasinska-Wisniewska A, Rodzki M, Witkowska A, Gasecka A Cells. 2022; 11(7).

PMID: 35406687 PMC: 8997598. DOI: 10.3390/cells11071124.

Prospective validation of the EuroSCORE II risk model in a single Dutch cardiac surgery centre.

Hogervorst E, Rosseel P, van de Watering L, Brand A, Bentala M, van der Meer B Neth Heart J. 2018; 26(11):540-551.

PMID: 30232783 PMC: 6220016. DOI: 10.1007/s12471-018-1161-x.

Validation of SinoSCORE for isolated CABG operation in East China.

Ma X, Wang Y, Shan L, Cang Z, Gu C, Qu N Sci Rep. 2017; 7(1):16806.

PMID: 29196738 PMC: 5711857. DOI: 10.1038/s41598-017-16925-x.

References

Berman M, Stamler A, Sahar G, Georghiou G, Sharoni E, Brauner R . Validation of the 2000 Bernstein-Parsonnet score versus the EuroSCORE as a prognostic tool in cardiac surgery. Ann Thorac Surg. 2006; 81(2):537-40. DOI: 10.1016/j.athoracsur.2005.08.017. View

Youn Y, Kwak Y, Yoo K . Can the EuroSCORE predict the early and mid-term mortality after off-pump coronary artery bypass grafting?. Ann Thorac Surg. 2007; 83(6):2111-7. DOI: 10.1016/j.athoracsur.2007.02.060. View

Michel P, Roques F, Nashef S . Logistic or additive EuroSCORE for high-risk patients?. Eur J Cardiothorac Surg. 2003; 23(5):684-7; discussion 687. DOI: 10.1016/s1010-7940(03)00074-5. View

McClish D . Combining and comparing area estimates across studies or strata. Med Decis Making. 1992; 12(4):274-9. DOI: 10.1177/0272989X9201200405. View

Geissler H, Holzl P, Marohl S, Kuhn-Regnier F, Mehlhorn U, Sudkamp M . Risk stratification in heart surgery: comparison of six score systems. Eur J Cardiothorac Surg. 2000; 17(4):400-6. DOI: 10.1016/s1010-7940(00)00385-7. View

Stroup D, Berlin J, Morton S, Olkin I, Williamson G, Rennie D . Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000; 283(15):2008-12. DOI: 10.1001/jama.283.15.2008. View

Nashef S, Roques F, Hammill B, Peterson E, Michel P, Grover F . Validation of European System for Cardiac Operative Risk Evaluation (EuroSCORE) in North American cardiac surgery. Eur J Cardiothorac Surg. 2002; 22(1):101-5. DOI: 10.1016/s1010-7940(02)00208-7. View

Al-Ruzzeh S, Asimakopoulos G, Ambler G, Omar R, Hasan R, Fabri B . Validation of four different risk stratification systems in patients undergoing off-pump coronary artery bypass surgery: a UK multicentre analysis of 2223 patients. Heart. 2003; 89(4):432-5. PMC: 1769277. DOI: 10.1136/heart.89.4.432. View

Whiting P, Rutjes A, Reitsma J, Bossuyt P, Kleijnen J . The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol. 2003; 3:25. PMC: 305345. DOI: 10.1186/1471-2288-3-25. View

10.

Yap C, Mohajeri M, Ihle B, Wilson A, Goyal S, Yii M . Validation of Euroscore model in an Australian patient population. ANZ J Surg. 2005; 75(7):508-12. DOI: 10.1111/j.1445-2197.2005.03440.x. View

11.

Kolh P . Importance of risk stratification models in cardiac surgery. Eur Heart J. 2006; 27(7):768-9. DOI: 10.1093/eurheartj/ehi792. View

12.

Biancari F, Kangasniemi O, Luukkonen J, Vuorisalo S, Satta J, Pokela R . EuroSCORE predicts immediate and late outcome after coronary artery bypass surgery. Ann Thorac Surg. 2006; 82(1):57-61. DOI: 10.1016/j.athoracsur.2005.11.039. View

13.

Zhou X . Empirical Bayes combination of estimated areas under ROC curves using estimating equations. Med Decis Making. 1996; 16(1):24-8. DOI: 10.1177/0272989X9601600109. View

14.

Yap C, Reid C, Yii M, Rowland M, Mohajeri M, Skillington P . Validation of the EuroSCORE model in Australia. Eur J Cardiothorac Surg. 2006; 29(4):441-6. DOI: 10.1016/j.ejcts.2005.12.046. View

15.

Toumpoulis I, Anagnostopoulos C, DeRose J, Swistel D . Does EuroSCORE predict length of stay and specific postoperative complications after coronary artery bypass grafting?. Int J Cardiol. 2005; 105(1):19-25. DOI: 10.1016/j.ijcard.2004.10.067. View

16.

Gogbashian A, Sedrakyan A, Treasure T . EuroSCORE: a systematic review of international performance. Eur J Cardiothorac Surg. 2004; 25(5):695-700. DOI: 10.1016/j.ejcts.2004.02.022. View

17.

Roques F, Nashef S, Michel P, Gauducheau E, De Vincentiis C, Baudet E . Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients. Eur J Cardiothorac Surg. 1999; 15(6):816-22; discussion 822-3. DOI: 10.1016/s1010-7940(99)00106-2. View

18.

Wagner R, Metz C, Campbell G . Assessment of medical imaging systems and computer aids: a tutorial review. Acad Radiol. 2007; 14(6):723-48. DOI: 10.1016/j.acra.2007.03.001. View

19.

DErrigo P, Seccareccia F, Rosato S, Manno V, Badoni G, Fusco D . Comparison between an empirically derived model and the EuroSCORE system in the evaluation of hospital performance: the example of the Italian CABG Outcome Project. Eur J Cardiothorac Surg. 2008; 33(3):325-33. DOI: 10.1016/j.ejcts.2007.12.001. View

20.

Omar R, Ambler G, Royston P, Eliahoo J, Taylor K . Cardiac surgery risk modeling for mortality: a review of current practice and suggestions for improvement. Ann Thorac Surg. 2004; 77(6):2232-7. DOI: 10.1016/j.athoracsur.2003.10.032. View