EJCTS Click here for details of sales representative
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
 QUICK SEARCH:   [advanced]


     


This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Michael Yii
Michael A. Rowland
Morteza Mohajeri
Peter D. Skillington
Siven Seevanayagam
Julian A. Smith
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Yap, C.-H.
Right arrow Articles by Smith, J. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Yap, C.-H.
Right arrow Articles by Smith, J. A.
Related Collections
Right arrow Professional affairs
Right arrow Cardiac - other
Right arrow Coronary disease

Eur J Cardiothorac Surg 2006;29:441-446
© 2006 Elsevier Science NL

Validation of the EuroSCORE model in Australia

Cheng-Hon Yap a , 1 , * , Christopher Reid b , 1 , Michael Yii a , 1 , Michael A. Rowland c , 1 , Morteza Mohajeri d , 1 , Peter D. Skillington e , 1 , Siven Seevanayagam f , 1 , Julian A. Smith g , 1

a Department of Cardiothoracic Surgery, St Vincent's Hospital Melbourne, Melbourne, Australia
b Baker Heart Research Institute and CCRE Therapeutics, Monash University, Melbourne, Australia
c The Alfred Hospital, Melbourne, Australia
d The Geelong Hospital, Melbourne, Australia
e Royal Melbourne Hospital, Melbourne, Australia
f The Austin Hospital, Melbourne, Australia
g Monash Medical Centre, Melbourne, Australia

Received 2 November 2005; received in revised form 28 December 2005; accepted 29 December 2005.

* Corresponding author. Address: Department of Surgery, Geelong Hospital, Geelong, Vic. 3220, Australia. Tel.: +61 40201 5001; fax: +61 35226 7019. (Email: yapch{at}svhm.org.au).

Objective: There is an important role for accurate risk prediction models in current cardiac surgical practice. Such models enable benchmarking and allow surgeons and institutions to compare outcomes in a meaningful way. They can also be useful in the areas of surgical decision-making, preoperative informed consent, quality assurance and healthcare management. The aim of this study was to assess the performance of the European System for Cardiac Operative Risk Evaluation (EuroSCORE) model on the Australasian Society of Cardiac and Thoracic Surgeons (ASCTS) patient database. Methods: The additive and logistic EuroSCORE models were applied to all patients undergoing cardiac surgery at six institutions in the state of Victoria between 1st July 2001 and 4th July 2005 within the ASCTS database who have complete data. The entire cohort and a subgroup of patients undergoing coronary artery bypass grafting (CABG) only were analysed. Observed and predicted mortalities were compared. Model discrimination was tested by determining the area under the receiver operating characteristic (ROC) curve. Model calibration was tested by the Hosmer–Lemeshow chi-square test. Results: Eight thousand three hundred and thirty-one patients with complete data were analysed. There were significant differences in the prevalence of risk factors between the ASCTS and European cardiac surgical populations. Observed mortality was 3.20% overall and 2.00% for the CABG only group. The EuroSCORE models over estimated mortality (entire cohort: additive predicted 5.31%, logistic predicted 8.76%; CABG only: additive predicted 4.25%, logistic predicted 6.19%). Discriminative power of both models was very good. Area under ROC curve was 0.83 overall and 0.82 for the CABG only group. Calibration of both models was poor as mortality was over predicted at nearly all risk deciles. Hosmer–Lemeshow chi-square test returned P-values less than 0.05. Conclusions: The additive and logistic EuroSCORE does not accurately predict outcomes in this group of cardiac surgery patients from six Australian institutions. Hence, the use of the EuroSCORE models for risk prediction may not be appropriate in Australia. A model, which accurately predicts outcomes in Australian cardiac surgical patients, is required.

Key Words: Cardiac surgery • Risk score • Mortality • EuroSCORE




This article has been cited by other articles:


Home page
Ann. Thorac. Surg.Home page
C.-H. Yap, L. Lau, M. Krishnaswamy, M. Gaskell, and M. Yii
Age of transfused red cells and early outcomes after cardiac surgery.
Ann. Thorac. Surg., August 1, 2008; 86(2): 554 - 559.
[Abstract] [Full Text] [PDF]


Home page
HeartHome page
M. R Ward and B. Bridgewater
Implications of publishing surgical results
Heart, September 1, 2007; 93(9): 1136 - 1136.
[Full Text] [PDF]


Home page
Eur. J. Cardiothorac. Surg.Home page
C. A. Mestres, M. A. Castro, E. Bernabeu, M. Josa, R. Cartana, J. L. Pomar, J. M. Miro, J. Mulet, and the Hospital Clinico Endocarditis Study Group
Preoperative risk stratification in infective endocarditis. Does the EuroSCORE model work? Preliminary results
Eur. J. Cardiothorac. Surg., August 1, 2007; 32(2): 281 - 285.
[Abstract] [Full Text] [PDF]


Home page
ICVTSHome page
P. E. Antunes, L. Eugenio, J. Ferrao de Oliveira, and M. J. Antunes
Mortality risk prediction in coronary surgery: a locally developed model outperforms external risk models
Interactive CardioVascular and Thoracic Surgery, August 1, 2007; 6(4): 437 - 441.
[Abstract] [Full Text] [PDF]


Home page
JAMAHome page
D. N. Wijeysundera, K. Karkouti, J.-Y. Dupuis, V. Rao, C. T. Chan, J. T. Granton, and W. S. Beattie
Derivation and Validation of a Simplified Predictive Index for Renal Replacement Therapy After Cardiac Surgery
JAMA, April 25, 2007; 297(16): 1801 - 1809.
[Abstract] [Full Text] [PDF]


Home page
J. Thorac. Cardiovasc. Surg.Home page
M. Paul, A. Raz, L. Leibovici, H. Madar, R. Holinger, and B. Rubinovitch
Sternal wound infection after coronary artery bypass graft surgery: Validation of existing risk scores
J. Thorac. Cardiovasc. Surg., February 1, 2007; 133(2): 397 - 403.
[Abstract] [Full Text] [PDF]


Home page
HeartHome page
B E Keogh
Logistic, additive or historical: is EuroSCORE an appropriate model for comparing individual surgeons' performance?
Heart, December 1, 2006; 92(12): 1715 - 1716.
[Abstract] [Full Text] [PDF]


Home page
Eur. J. Cardiothorac. Surg.Home page
I. Florath, A. Albert, W. Hassanein, B. Arnrich, U. Rosendahl, I. C. Ennker, and J. Ennker
Current determinants of 30-day and 3-month mortality in over 2000 aortic valve replacements: impact of routine laboratory parameters
Eur. J. Cardiothorac. Surg., November 1, 2006; 30(5): 716 - 721.
[Abstract] [Full Text] [PDF]




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2006 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.