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Eur J Cardiothorac Surg 1999;15:816-823
© 1999 Elsevier Science NL
Service de chirurgie cardiovasculaire, CHU de Fort de France, 97200Martinique, France
Received 22 September 1998; received in revised form 8 March 1999; accepted 11 March 1999.
Corresponding author. Tel.: +596-552271; fax: +596-758438; email: f.r.fwi@wanadoo.fr
Objective: To assess risk factors for mortality in cardiac surgical adult patients as part of a study to develop a European System for Cardiac Operative Risk Evaluation (EuroSCORE). Methods: From September to November 1995, information on risk factors and mortality was collected for 19030 consecutive adult patients undergoing cardiac surgery under cardiopulmonary bypass in 128 surgical centres in eight European states. Data were collected for 68 preoperative and 29 operative risk factors proven or believed to influence hospital mortality. The relationship between risk factors and outcome was assessed by univariate and logistic regression analysis. Results: Mean age (± standard deviation) was 62.5±10.7 (range 1794 years) and 28% were female. Mean body mass index was 26.3±3.9. The incidence of common risk factors was as follows: hypertension 43.6%, diabetes 16.7%, extracardiac arteriopathy 2.9%, chronic renal failure 3.5%, chronic pulmonary disease 3.9%, previous cardiac surgery 7.3% and impaired left ventricular function 31.4%. Isolated coronary surgery accounted for 63.6% of all procedures, and 29.8% of patients had valve operations. Overall hospital mortality was 4.8%. Coronary surgery mortality was 3.4% In the absence of any identifiable risk factors, mortality was 0.4% for coronary surgery, 1% for mitral valve surgery, 1.1% for aortic valve surgery and 0% for atrial septal defect repair. The following risk factors were associated with increased mortality: age (P=0.001), female gender (P=0.001), serum creatinine (P=0.001), extracardiac arteriopathy (P=0.001), chronic airway disease (P=0.006), severe neurological dysfunction (P=0.001), previous cardiac surgery (P=0.001), recent myocardial infarction (P=0.001), left ventricular ejection fraction (P=0.001), chronic congestive cardiac failure (P=0.001), pulmonary hypertension (P=0.001), active endocarditis (P=0.001), unstable angina (P=0.001), procedure urgency (P=0.001), critical preoperative condition (P=0.001) ventricular septal rupture (P=0.002), non-coronary surgery (P=0.001), thoracic aortic surgery (P=0.001). Conclusion: A number of risk factors contribute to cardiac surgical mortality in Europe. This information can be used to develop a risk stratification system for the prediction of hospital mortality and the assessment of quality of care.
Key Words: Risk factors EuroSCORE database
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S. Gunaydin, K. McCusker, V. Vijay, S. Isbir, T. Sari, M. A. Onur, A. Gurpinar, A. Sezgin, M. F Sargon, T. Tezcaner, et al. Comparison of polymethoxyethylacrylate-coated circuits with leukocyte filtration and reduced heparinization protocol on heparin-bonded circuits in different risk cohorts Perfusion, November 1, 2006; 21(6): 329 - 342. [Abstract] [PDF] |
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E. Grube, J. C. Laborde, U. Gerckens, T. Felderhoff, B. Sauren, L. Buellesfeld, R. Mueller, M. Menichelli, T. Schmidt, B. Zickmann, et al. Percutaneous Implantation of the CoreValve Self-Expanding Valve Prosthesis in High-Risk Patients With Aortic Valve Disease: The Siegburg First-in-Man Study Circulation, October 10, 2006; 114(15): 1616 - 1624. [Abstract] [Full Text] [PDF] |
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B. L. Croal, G. S. Hillis, P. H. Gibson, M. T. Fazal, H. El-Shafei, G. Gibson, R. R. Jeffrey, K. G. Buchan, D. West, and B. H. Cuthbertson Relationship Between Postoperative Cardiac Troponin I Levels and Outcome of Cardiac Surgery Circulation, October 3, 2006; 114(14): 1468 - 1475. [Abstract] [Full Text] [PDF] |
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T. Nishida, M. Masuda, Y. Tomita, S. Tokunaga, Y. Tanoue, A. Shiose, S. Morita, and R. Tominaga The logistic EuroSCORE predicts the hospital mortality of the thoracic aortic surgery in consecutive 327 Japanese patients better than the additive EuroSCORE. Eur. J. Cardiothorac. Surg., October 1, 2006; 30(4): 578 - 582. [Abstract] [Full Text] [PDF] |
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R. Salem, A. Y. Denault, P. Couture, S. Belisle, A. Fortier, M.-C. Guertin, M. Carrier, and R. Martineau Left ventricular end-diastolic pressure is a predictor of mortality in cardiac surgery independently of left ventricular ejection fraction Br. J. Anaesth., September 1, 2006; 97(3): 292 - 297. [Abstract] [Full Text] [PDF] |
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N. Hudorovic Reduction in hospitalisation rates following simultaneous carotid endarterectomy and coronary artery bypass grafting; experience from a single centre Interactive CardioVascular and Thoracic Surgery, August 1, 2006; 5(4): 367 - 372. [Abstract] [Full Text] [PDF] |
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B. J. Leavitt, C. S. Ross, B. Spence, S. D. Surgenor, E. M. Olmstead, R. A. Clough, D. C. Charlesworth, R. S. Kramer, G. T. O'Connor, and for the Northern New England Cardiovascular Diseas Long-Term Survival of Patients With Chronic Obstructive Pulmonary Disease Undergoing Coronary Artery Bypass Surgery Circulation, July 4, 2006; 114(1_suppl): I-430 - I-434. [Abstract] [Full Text] [PDF] |
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T. Walther, A. Rastan, V. Falk, S. Lehmann, J. Garbade, A. K. Funkat, F. W. Mohr, and J. F. Gummert Patient prosthesis mismatch affects short- and long-term outcomes after aortic valve replacement. Eur. J. Cardiothorac. Surg., July 1, 2006; 30(1): 15 - 19. [Abstract] [Full Text] [PDF] |
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J. Nilsson, M. Ohlsson, L. Thulin, P. Hoglund, S. A.M. Nashef, and J. Brandt Risk factor identification and mortality prediction in cardiac surgery using artificial neural networks J. Thorac. Cardiovasc. Surg., July 1, 2006; 132(1): 12 - 19. [Abstract] [Full Text] [PDF] |
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N. Chaudhuri, J. James, A. Sheikh, A. D. Grayson, and B. M. Fabri Intestinal ischaemia following cardiac surgery: a multivariate risk model. Eur. J. Cardiothorac. Surg., June 1, 2006; 29(6): 971 - 977. [Abstract] [Full Text] [PDF] |
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C.-J. Jakobsen, P. Torp, and E. Sloth Assessment of left ventricular ejection fraction may invalidate the reliability of EuroSCORE. Eur. J. Cardiothorac. Surg., June 1, 2006; 29(6): 978 - 982. [Abstract] [Full Text] [PDF] |
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K. Matsuura, H. Ogino, H. Matsuda, K. Minatoya, H. Sasaki, T. Yagihara, and S. Kitamura Limitations of EuroSCORE for Measurement of Risk-Stratified Mortality in Aortic Arch Surgery Using Selective Cerebral Perfusion: Is Advanced Age No Longer a Risk? Ann. Thorac. Surg., June 1, 2006; 81(6): 2084 - 2087. [Abstract] [Full Text] [PDF] |
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T. Walther, T. Dewey, G. Wimmer-Greinecker, M. Doss, R. Hambrecht, G. Schuler, F. W. Mohr, and M. Mack Transapical approach for sutureless stent-fixed aortic valve implantation: experimental results. Eur. J. Cardiothorac. Surg., May 1, 2006; 29(5): 703 - 708. [Abstract] [Full Text] [PDF] |
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K. Hekmat, U. Mehlhorn, and T. Wahlers Do we need the new Italian risk stratification model for CABG patients? Eur. J. Cardiothorac. Surg., May 1, 2006; 29(5): 856 - 857. [Full Text] [PDF] |
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M. Cladellas, J. Bruguera, J. Comin, J. Vila, E. de Jaime, J. Marti, and M. Gomez Is pre-operative anaemia a risk marker for in-hospital mortality and morbidity after valve replacement? Eur. Heart J., May 1, 2006; 27(9): 1093 - 1099. [Abstract] [Full Text] [PDF] |
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M. Valgimigli, P. Malagutti, G. A. Rodriguez-Granillo, H. M. Garcia-Garcia, J. Polad, K. Tsuchida, E. Regar, W. J. Van der Giessen, P. de Jaegere, P. De Feyter, et al. Distal Left Main Coronary Disease Is a Major Predictor of Outcome in Patients Undergoing Percutaneous Intervention in the Drug-Eluting Stent Era: An Integrated Clinical and Angiographic Analysis Based on the Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH) and Taxus-Stent Evaluated At Rotterdam Cardiology Hospital (T-SEARCH) Registries J. Am. Coll. Cardiol., April 18, 2006; 47(8): 1530 - 1537. [Abstract] [Full Text] [PDF] |
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