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Editorial comment

Predicting operative risk: a worthy task — an elusive goal

^a Cardiopulmonary Research Science and Technology Institute, Dallas, TX, 75230, USA
^b Medical City Dallas Hospital, Dallas, TX, 75230, USA

^_* Corresponding author. Address: 7777 Forest Lane, Suite A323, Dallas, TX 75230, USA. Tel.: +1 972 566 4866. (Email: TDewey@CSANT.com).

Key Words: Outcomes • Mortality • Cardiac surgery

The first 20% of the full text of this article appears below.

Risk scoring models are tools that have been developed to anticipate expected patient mortality with certain surgical procedures. These scores can be used in many ways: to compare operative results from different centres, as a tool for performance improvement within individual institutions or to select appropriate patients for inclusion or exclusion in clinical trials [1]. Fundamental to this process, however, is the accuracy with which the model performs in predicting mortality. The European System for Cardiac Operative Risk Evaluation (EuroSCORE) is one such instrument designed to predict operative mortality, and subsequently enable the reporting of risk-adjusted mortality as opposed to raw mortality. This tool was developed using patient demographics and operative outcomes in 19,030 patients from 128 centres performing cardiac surgery [2]. The additive EuroSCORE was the first model available for use. The logistic model was subsequently developed to provide greater precision in higher-risk patients. While several reports validate its findings in patients undergoing coronary artery bypass grafting, increasing concerns over its apparent over-estimation of mortality in higher-risk patients has led to a re-evaluation of its effectiveness.

The article by Ranucci and colleagues in this journal is an . . . [Full Text of this Article]