HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Shishir Karthik Arun K. Srinivasan Antony D. Grayson David A.C. Sharpe Daniel J.M. Keenan Brian M. Fabri Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Karthik, S. Articles by Fabri, B. M. Search for Related Content PubMed PubMed Citation Articles by Karthik, S. Articles by Fabri, B. M. Related Collections Coronary disease

Eur J Cardiothorac Surg 2004;26:318-322
© 2004 Elsevier Science NL

Limitations of additive EuroSCORE for measuring risk stratified mortality in combined coronary and valve surgery

^a Department of Cardiothoracic Surgery and Clinical Governance, The Cardiothoracic Centre-Liverpool, Thomas Drive, Liverpool L14 3PE, UK
^b Department of Cardiothoracic Surgery, Blackpool Victoria Hospital, Blackpool, UK
^c Department of Cardiothoracic Surgery, Manchester Royal Infirmary, Manchester, UK
^d Department of Cardiothoracic Surgery, Wythenshawe Hospital, Manchester, UK

Received 14 November 2003; received in revised form 12 January 2004; accepted 9 February 2004.

^* Corresponding author. Tel.: +151-293-2397; fax: +151-220-8573
e-mail: brian.fabri{at}ctc.nhs.uk

Objective: To study the use of the additive and logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) to predict mortality following adult combined coronary artery bypass grafting (CABG) and valve surgery. Methods: Data were collected prospectively, from all four centres providing adult cardiac surgery in the north west of England, on 1769 consecutive patients undergoing combined CABG and valve surgery between April 1997 and March 2002. Observed in-hospital mortality was compared to predicted mortality as determined by both additive and logistic EuroSCORE. Results: Observed mortality for simultaneous CABG and valve surgery was 8.7%, compared to 6.7% (additive) and 9.4% (logistic). Sixty-five percent of patients were classified as high-risk (additive EuroSCORE >5); the observed mortality was 11.5%, compared to 8.1% (additive) and 12.8% (logistic). Discrimination was similar in both systems as measured by the C statistic (additive 0.73, logistic 0.73). Conclusions: The logistic EuroSCORE is more accurate at predicting mortality in simultaneous CABG and valve surgery, as the additive EuroSCORE significantly under-predicts in this high-risk group.

Key Words: EuroSCORE • Risk stratification • Simultaneous coronary artery bypass grafting • Valve surgery

This article has been cited by other articles:

				C. Diez, P. Mohr, O. Kuss, B. Osten, R.-E. Silber, and H.-S. Hofmann Impact of Preoperative Renal Dysfunction on In-hospital Mortality After Solitary Valve and Combined Valve and Coronary Procedures. Ann. Thorac. Surg., March 1, 2009; 87(3): 731 - 736. [Abstract] [Full Text] [PDF]

				P. T.L. Chiam and C. E. Ruiz Percutaneous Transcatheter Aortic Valve Implantation: Assessing Results, Judging Outcomes, and Planning Trials: The Interventionalist Perspective J. Am. Coll. Cardiol. Intv., August 1, 2008; 1(4): 341 - 350. [Abstract] [Full Text] [PDF]

				S W Grant, A D Grayson, M Jackson, J Au, B M Fabri, G Grotte, M Jones, and B Bridgewater Does the choice of risk-adjustment model influence the outcome of surgeon-specific mortality analysis? A retrospective analysis of 14 637 patients under 31 surgeons Heart, August 1, 2008; 94(8): 1044 - 1049. [Abstract] [Full Text] [PDF]

				M. Kuduvalli, A. D. Grayson, J. Au, G. Grotte, B. Bridgewater, B. M. Fabri, and on behalf of the North West Quality Improvement Pr A multi-centre additive and logistic risk model for in-hospital mortality following aortic valve replacement Eur. J. Cardiothorac. Surg., April 1, 2007; 31(4): 607 - 613. [Abstract] [Full Text] [PDF]

				F Bhatti, A D Grayson, G Grotte, B M Fabri, J Au, M Jones, B Bridgewater, and on behalf of the North West Quality Improvement Pr The logistic EuroSCORE in cardiac surgery: how well does it predict operative risk? Heart, December 1, 2006; 92(12): 1817 - 1820. [Abstract] [Full Text] [PDF]

				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]

				Determinants of operative mortality in valvular heart surgery. J. Thorac. Cardiovasc. Surg., March 1, 2006; 131(3): 547 - 557.

				R. Jin, G. L. Grunkemeier, and For the Providence Health System Cardiovascular St Additive vs. logistic risk models for cardiac surgery mortality Eur. J. Cardiothorac. Surg., August 1, 2005; 28(2): 240 - 243. [Abstract] [Full Text] [PDF]