P-37 The evaluation of European system for cardiac operative risk evaluation and cardiac surgery scoring system to predict morbidity and mortality in open heart surgery

Abstract

IntroductionScoring systems that allow peri- and postoperative risk estimation in cardiac surgery have become increasingly important in current clinical practice for both anaesthesiologist and surgeons. Thus, we performed assessment of discriminatory power of the European System for Cardiac Operative Risk Evaluation (EuroSCORE) and Cardiac Surgical Score (CASUS) scoring systems [1Hekmat K. Doerr F. Kroner A. et al.Prediction of mortality in intensive Care Unit cardiac surgical patients.Eur J Cardiothorac Surg. 2010; 38: 104-109Crossref PubMed Scopus (25) Google Scholar, 2Roques F. Nashef S.A. Michel P. et al.Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients.Eur J Cardiothorac Surg. 1999; 15: 816-822Crossref PubMed Scopus (1454) Google Scholar].MethodA retrospective cohort design was used. The EuroSCORE and CASUS were determined for all consecutive patients who underwent conventional open heart surgery between June 2008 and June 2010 at our university hospital. Discrimination or the ability of a scoring system to distinguish between survival and mortality was measured by the area under the Receiver Operating Characteristic (ROC) curve. The ROC curve shows the relation between sensitivity and specificity. We evaluated correlation between these scoring systems with Spearman's correlation coefficient test.ResultsTwo hundred and nine patients were included with a mean age of 62.8±9.1 yr. Hospital mortality was 5.3% (11 patients). Mean score for alive and dead patients for EuroSCORE was 4±4.01 and 8.1±17.1. Mean score for alive and dead patients for CASUS was 1.48±4.01 and 11.8±7.1 (P<0.05). The area under the ROC curve was 0.817 for EuroSCORE system and was 0.940 for CASUS (P<0.05). There was a positive correlation between EuroSCORE and CASUS scorings systems (r:0.54, P<0.001).ConclusionAlthough limited by the low number of deaths, both of these scoring systems had significance in mortality prediction in our patient population. These scoring systems are a clinically relevant index not only for European but also for open heart surgery patients in Turkey. CASUS and EuroSCORE scoring systems can be used together for the best predictions about morbidity and mortality rate. We use these scoring systems together because we believe that they may serve as an expectation system for diagnosing organ failure and predicting mortality rate. IntroductionScoring systems that allow peri- and postoperative risk estimation in cardiac surgery have become increasingly important in current clinical practice for both anaesthesiologist and surgeons. Thus, we performed assessment of discriminatory power of the European System for Cardiac Operative Risk Evaluation (EuroSCORE) and Cardiac Surgical Score (CASUS) scoring systems [1Hekmat K. Doerr F. Kroner A. et al.Prediction of mortality in intensive Care Unit cardiac surgical patients.Eur J Cardiothorac Surg. 2010; 38: 104-109Crossref PubMed Scopus (25) Google Scholar, 2Roques F. Nashef S.A. Michel P. et al.Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients.Eur J Cardiothorac Surg. 1999; 15: 816-822Crossref PubMed Scopus (1454) Google Scholar]. Scoring systems that allow peri- and postoperative risk estimation in cardiac surgery have become increasingly important in current clinical practice for both anaesthesiologist and surgeons. Thus, we performed assessment of discriminatory power of the European System for Cardiac Operative Risk Evaluation (EuroSCORE) and Cardiac Surgical Score (CASUS) scoring systems [1Hekmat K. Doerr F. Kroner A. et al.Prediction of mortality in intensive Care Unit cardiac surgical patients.Eur J Cardiothorac Surg. 2010; 38: 104-109Crossref PubMed Scopus (25) Google Scholar, 2Roques F. Nashef S.A. Michel P. et al.Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients.Eur J Cardiothorac Surg. 1999; 15: 816-822Crossref PubMed Scopus (1454) Google Scholar]. MethodA retrospective cohort design was used. The EuroSCORE and CASUS were determined for all consecutive patients who underwent conventional open heart surgery between June 2008 and June 2010 at our university hospital. Discrimination or the ability of a scoring system to distinguish between survival and mortality was measured by the area under the Receiver Operating Characteristic (ROC) curve. The ROC curve shows the relation between sensitivity and specificity. We evaluated correlation between these scoring systems with Spearman's correlation coefficient test. A retrospective cohort design was used. The EuroSCORE and CASUS were determined for all consecutive patients who underwent conventional open heart surgery between June 2008 and June 2010 at our university hospital. Discrimination or the ability of a scoring system to distinguish between survival and mortality was measured by the area under the Receiver Operating Characteristic (ROC) curve. The ROC curve shows the relation between sensitivity and specificity. We evaluated correlation between these scoring systems with Spearman's correlation coefficient test. ResultsTwo hundred and nine patients were included with a mean age of 62.8±9.1 yr. Hospital mortality was 5.3% (11 patients). Mean score for alive and dead patients for EuroSCORE was 4±4.01 and 8.1±17.1. Mean score for alive and dead patients for CASUS was 1.48±4.01 and 11.8±7.1 (P<0.05). The area under the ROC curve was 0.817 for EuroSCORE system and was 0.940 for CASUS (P<0.05). There was a positive correlation between EuroSCORE and CASUS scorings systems (r:0.54, P<0.001). Two hundred and nine patients were included with a mean age of 62.8±9.1 yr. Hospital mortality was 5.3% (11 patients). Mean score for alive and dead patients for EuroSCORE was 4±4.01 and 8.1±17.1. Mean score for alive and dead patients for CASUS was 1.48±4.01 and 11.8±7.1 (P<0.05). The area under the ROC curve was 0.817 for EuroSCORE system and was 0.940 for CASUS (P<0.05). There was a positive correlation between EuroSCORE and CASUS scorings systems (r:0.54, P<0.001). ConclusionAlthough limited by the low number of deaths, both of these scoring systems had significance in mortality prediction in our patient population. These scoring systems are a clinically relevant index not only for European but also for open heart surgery patients in Turkey. CASUS and EuroSCORE scoring systems can be used together for the best predictions about morbidity and mortality rate. We use these scoring systems together because we believe that they may serve as an expectation system for diagnosing organ failure and predicting mortality rate. Although limited by the low number of deaths, both of these scoring systems had significance in mortality prediction in our patient population. These scoring systems are a clinically relevant index not only for European but also for open heart surgery patients in Turkey. CASUS and EuroSCORE scoring systems can be used together for the best predictions about morbidity and mortality rate. We use these scoring systems together because we believe that they may serve as an expectation system for diagnosing organ failure and predicting mortality rate.