Assesment of the EuroSCORE as a predictor for mortality in valve cardiac surgery at the Heart Institute of Pernambuco

• Published in: Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular Vol. 25; no. 1; p. 11
• Main Authors: Andrade, Isaac Newton Guimarães, Moraes Neto, Fernando Ribeiro de, Oliveira, João Paulo Segundo de Paiva, Silva, Igor Tiago Correia, Andrade, Tamyris Guimarães, Moraes, Carlos Roberto Ribeiro de
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil 01-01-2010
• Subjects: Aged; Brazil - epidemiology; Cardiac Care Facilities; Cardiac Surgical Procedures - mortality; Epidemiologic Methods; Female; Heart Valves - surgery; Humans; Male; Middle Aged; Risk Assessment - methods; Risk Assessment - standards; Risk Factors; Survivors - statistics & numerical data; Brazil
• DOI: 10.1590/S0102-76382010000100007

To assess the applicability of the European Risk System in Cardiac Operations (EuroSCORE) in patients undergoing cardiac valve surgery at the Heart Institute of Pernambuco.
840 patients operated on between 2001 and 2009, who medical records contained all the informations to calculate the EuroSCORE were included in the study. Hospital death was the end-point of the study. In order to assess the applicability of the EuroSCORE it was used the non parametric test of Mann-Whitney. The calibration of the model was measured by comparing the morbidity observed with that expected, using the Hosmer-Lemeshow Test of Goodness of Fit. The accuracy of the model was evaluated by the ROC curve (receiver operating characteristic curve).
The comparison of expected and observed mortality, by Hosmer-Lemershow test, showed good predictive capacity (P = 0.767) as well as when compared to each value of addictive EuroSCORE (P = 0,455). The area of ROC curve was 0.731 (IC 95%, 0.660 - 0.793) with P < 0.001. The global predicted mortality was practically identical to that observed (7.9%). The low-risk group (EuroSCORE 0-2) comprised 345 patients with a mortality of 3.19%. The medium-risk group (EuroSCORE 3-5) comprised 364 patients, with a mortality of 7.69% and the high-risk group (EuroSCORE > 6) included 131 patients, with a mortality of 20.6%. The regression logistic analyses allowed to identify the following risk-factors for death: age > 60 years, gender female, previous operation, active endocarditis, associated surgery of the thoracic aorta and extra-cardiac arteriopathy.
The EuroSCORE, a simple and objective method, proved to be a satisfactory predictor of operative mortality and risk factors for death in patients submitted to valve cardiac operations in the Heart Institute of Pernambuco.