Evaluation of cardiac operative risk and outcome using EuroSCORE II for coronary artery bypass graft surgery

Abstract

Background: The original EuroSCORE was proposed in 1995, with a predicted mortality rate of 3.9%. The study aimed to assess the validity of the European System for Cardiac Operative Risk Evaluation-II (EuroSCORE II), presented in 2012, in predicting 30-day in-hospital mortality with the observed mortality in cardiac surgical patients operated in Universiti Kebangsaan Malaysia Medical Centre (UKMMC).Methodology: It was a retrospective study on patients who had undergone coronary artery bypass graft surgery during 6 y from January 01, 2011 to December 31, 2016, in UKMMC. Comparison between the output of the EuroSCORE II obtained and compared with the patients’ actual postoperative outcome. Results: The actual in-hospital mortality rate was 6.8%. In comparison, the predicted mortality rate by the median EuroSCORE II was 1.23%. Receiver operating characteristics (ROC) curve analysis showed an excellent discriminatory power with the area under the curve (AUC) of 0.844 (95% CI 0.705 - 0.983, P < 0.001) between the survivors and non-survivors. Conclusion: This single-center retrospective study of validation showed that the overall observed mortality was under-predicted by EuroSCORE II. However, it demonstrated a good calibration with excellent discriminatory power in predicting 30 days in-hospital mortality risk among patients undergoing coronary artery bypass graft surgery. Abbreviations: BMI: Body Mass Index; CCS: Canadian Cardiovascular Society; LVEF: Left Ventricular Ejection Fraction; NYHA: New York Heart Association; PA: Pulmonary Artery Key words: Risk assessment; Hospital mortality; Cardiac surgery Citation: Mokhtar MN, Abdullah FH, Rahman MRA, Ooi JSM. Evaluation of cardiac operative risk and outcome using EuroSCORE II for coronary artery bypass graft surgery. Anaesth. pain intensive care 2023;27(3):307−314; DOI: 10.35975/apic.v27i3.2228 Received: November 15, 2022; Reviewed: April 17, 2023; Accepted: April 19, 2023