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Master Thesis

Does EuroSCORE II improve the mortality prediction of high-risk patients in cardiac surgery?

Abstract : Objectives: To compare the EuroSCORE (ES) II prediction of death prior to cardiac surgery in high-risk patients with 4 other scores: additive ES, logistic ES, Parsonnet score and Tu score. Methods: Adult patients who underwent cardiac surgery between September 2012 and July 2016, were consecutively included. Patients who received heart transplantation or left ventricular assistance device were excluded. The 5 risk scores (ESII, additive ES, logistic ES, Parsonnet score, Tu score) were collected before surgery. Four high-risk groups of patients were identified: patients older than 80 years, combined cardiac surgery, surgery of the thoracic aorta and emergency cardiac surgery. Two low-risk groups were also studied: single valve surgery and coronary artery bypass surgery. The mortality predicted by each score was assessed using area under the receiver operating characteristics curve (AUC-ROC) and compared to the ESII. Results: There were 2306 patients admitted during the study period. Mortality rate at day 30 was 4.1% (95% confidence interval (CI) 3-5). The AUC-ROC of ESII was 0.79 (0.74-0.83), 0.77 (0.72-0.82), 0.70 (0.64-0.76), 0.79 (0.74-0.84), 0.86 (0.83-0.88) and 0.91 (0.88-0.93) for octogenarians, thoracic aortic surgery, combined surgery, emergency surgery, coronary surgery and valve surgery respectively. These AUC-ROC values were higher than those obtained with other scores. Conclusion: In high-risk patients for cardiac surgery, ESII didn’t significantly improve the prediction of day 30 mortality by comparison with other scores. Discrimination was good in low-risk groups but poor in high-risk groups.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01510246
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Submitted on : Wednesday, April 19, 2017 - 11:45:27 AM
Last modification on : Wednesday, July 15, 2020 - 8:58:04 AM

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  • HAL Id : dumas-01510246, version 1

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Laura Guillet. Does EuroSCORE II improve the mortality prediction of high-risk patients in cardiac surgery?. Human health and pathology. 2017. ⟨dumas-01510246⟩

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