학술논문
Prospective validation of the EuroSCORE II risk model in a single Dutch cardiac surgery centre.
Document Type
Academic Journal
Author
Hogervorst EK; Centre for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands. e.k.hogervorst@umcg.nl.; Jon J van Rood Centre for Clinical Transfusion Research, Leiden University Medical Centre, Leiden, The Netherlands. e.k.hogervorst@umcg.nl.; Department of Anaesthesiology, University of Groningen, Groningen, The Netherlands. e.k.hogervorst@umcg.nl.; University Medical Centre Groningen, Groningen, The Netherlands. e.k.hogervorst@umcg.nl.; Rosseel PMJ; Department of Anaesthesia and Intensive Care, Amphia Hospital, Breda, The Netherlands.; van de Watering LMG; Centre for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands.; Jon J van Rood Centre for Clinical Transfusion Research, Leiden University Medical Centre, Leiden, The Netherlands.; Brand A; Centre for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands.; Jon J van Rood Centre for Clinical Transfusion Research, Leiden University Medical Centre, Leiden, The Netherlands.; Bentala M; Department of Anaesthesia and Intensive Care, Amphia Hospital, Breda, The Netherlands.; van der Meer BJM; Department of Anaesthesia and Intensive Care, Amphia Hospital, Breda, The Netherlands.; TIAS, Tilburg University, Tilburg, The Netherlands.; van der Bom JG; Centre for Clinical Transfusion Research, Sanquin Research, Leiden, The Netherlands.; Jon J van Rood Centre for Clinical Transfusion Research, Leiden University Medical Centre, Leiden, The Netherlands.; Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands.
Source
Publisher: Bohn Stafleu van Loghum Country of Publication: Netherlands NLM ID: 101095458 Publication Model: Print Cited Medium: Print ISSN: 1568-5888 (Print) Linking ISSN: 15685888 NLM ISO Abbreviation: Neth Heart J Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
1568-5888
Abstract
Objective: The EuroSCORE I was one of the most frequently used pre-operative risk models in cardiac surgery. In 2011 it was replaced by its successor the EuroSCORE II. This study aims to validate the EuroSCORE II and to compare its performance with the EuroSCORE I in a Dutch hospital.
Methods: The EuroSCORE II was prospectively validated in 2,296 consecutive cardiac surgery patients between 1 April 2012 and 1 January 2014. Receiver operating characteristic curves on in-hospital mortality were plotted for EuroSCORE I and EuroSCORE II, and the area under the curve was calculated to assess discriminative power. Calibration was assessed by comparing observed versus expected mortality. Additionally, analyses were performed in which we stratified for type of surgery and for elective versus emergency surgery.
Results: The observed mortality was 2.4% (55 patients). The discriminative power of the EuroSCORE II surpassed that of the EuroSCORE I (area under the curve EuroSCORE II 0.871, 95% confidence interval (CI) 0.832-0.911; area under the curve additive EuroSCORE I 0.840, CI 0.798-0.882; area under the curve logistic EuroSCORE I 0.761, CI 0.695-0.828). Both the additive and the logistic EuroSCORE I overestimated mortality (predictive mortality additive EuroSCORE I median 5.0%, inter-quartile range 3.0-8.0%; logistic EuroSCORE I 10.7%, inter-quartile range 5.8-13.9), while the EuroSCORE II underestimated mortality (median 1.6%, inter-quartile range 1.0-3.5). In most stratified analyses the EuroSCORE II performed better.
Conclusion: Our results show that the EuroSCORE II produces a valid risk prediction and outperforms the EuroSCORE I in elective cardiac surgery patients.
Methods: The EuroSCORE II was prospectively validated in 2,296 consecutive cardiac surgery patients between 1 April 2012 and 1 January 2014. Receiver operating characteristic curves on in-hospital mortality were plotted for EuroSCORE I and EuroSCORE II, and the area under the curve was calculated to assess discriminative power. Calibration was assessed by comparing observed versus expected mortality. Additionally, analyses were performed in which we stratified for type of surgery and for elective versus emergency surgery.
Results: The observed mortality was 2.4% (55 patients). The discriminative power of the EuroSCORE II surpassed that of the EuroSCORE I (area under the curve EuroSCORE II 0.871, 95% confidence interval (CI) 0.832-0.911; area under the curve additive EuroSCORE I 0.840, CI 0.798-0.882; area under the curve logistic EuroSCORE I 0.761, CI 0.695-0.828). Both the additive and the logistic EuroSCORE I overestimated mortality (predictive mortality additive EuroSCORE I median 5.0%, inter-quartile range 3.0-8.0%; logistic EuroSCORE I 10.7%, inter-quartile range 5.8-13.9), while the EuroSCORE II underestimated mortality (median 1.6%, inter-quartile range 1.0-3.5). In most stratified analyses the EuroSCORE II performed better.
Conclusion: Our results show that the EuroSCORE II produces a valid risk prediction and outperforms the EuroSCORE I in elective cardiac surgery patients.