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Eur J Cardiothorac Surg 2004;25:695-700
© 2004 Elsevier Science NL
Review |
a The Royal College of Surgeons of England, 35-43 Lincoln's Inn Fields, London WC2A 3PN, UK
b Department of Cardiothoracic Surgery, Guy's and St Thomas' Hospital NHS Trust, Guy's Hospital, St Thomas Street, London SE1 9RT, UK
Received 31 December 2003; received in revised form 13 February 2004; accepted 19 February 2004.
* Corresponding author. Tel./fax: +44-208-731-6176
e-mail: andrew{at}cardiacforum.com
The validity of the cardiac surgical scoring system, EuroSCORE, has been assessed by several individual cardiac centres within and outside Europe. We chose to assess the overall international performance by systematic review of peer-reviewed literature. There were six studies meeting our criteria for assessment. Internationally, the evidence is highly suggestive that additive EuroSCORE performance generally over-estimates mortality at lower EuroSCOREs (EuroSCORE
6) and under-estimates mortality at higher EuroSCOREs (EuroSCORE>13). The effect of this could have serious misrepresentations for surgeons and hospitals operating on differing case-mixes. We suggest that further studies need to be performed on the logistic EuroSCORE calculation to ascertain whether predictive ability is improved. Overall, however, EuroSCORE is the most rigorously evaluated scoring system in cardiac surgery.
Key Words: Cardiac surgery • EuroSCORE • Mortality • Risk stratification
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