EuroSCORE

Operative mortality is a good measure of quality of cardiac surgical care, as long as patient risk factors are taken into consideration. EuroSCORE is a method of calculating predicted operative mortality for patients undergoing cardiac surgery.

Nearly 20 thousand consecutive patients from 128 hospitals in eight European countries were studied. Information was collected on 97 risk factors in all the patients. The outcome (survival or death) was related to the preoperative risk factors. The most important, reliable and objective risk factors were then used to prepare a scoring system. The scoring system was prepared from part of the database and tested and validated on another part. This scoring system is called EuroSCORE.

Comments:

EuroSCORE has now been replaced by EuroSCORE II because the previous version appeared to over-estimate the risk of death (“mortality is considerably overestimated by this score”) and has added several new Risk factors./p>
EuroSCORE

EuroSCORE (European System for Cardiac Operative Risk Evaluation)

 

Variables Values Beta (Logistic EuroSCORE) Points (EuroSCORE)
Age (years)
 
Female gender
Emergency
Serum creatinine > 200 µmol/ L
L.V.E.F.
C.O.P.D.
Surgery on thoracic aorta
Extracardiac arteriopathy
Neurological dysfunction
Active endocarditis
Critical preoperative state
Unstable angina
Recent myocardial infarction (< 90 days)
Systolic PAP > 60 mmHg
Previous cardiac surgery
Postinfarct. septal rupture
Other than isolated C.A.B.G.
Logistic EuroSCORE:

Logit = -4.789594 + Sum (beta)
+ 0.0666354 *Xi
(Xi = 1 if patient age < 60;
Xi increase by one point per year thereafter).
Predicted death Rate =
e(Logit) / (1 + e (Logit))
EuroSCORE:
EuroSCORE= Sum (points)

References

  1. Roques F, Nashef SA, Michel P, Gauducheau E, de Vincentiis C, Baudet E, Cortina J, David M, Faichney A, Gabrielle F, Gams E, Harjula A, Jones MT, Pintor PP, Salamon R, Thulin L. Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients. Eur J Cardiothorac Surg. 1999 Jun;15(6):816-22; discussion 822-3.
  2. Roques F, Michel P, Goldstone AR, Nashef SA. The logistic EuroSCORE. Eur Heart J. 2003 May;24(9):882-3
  3. The manuscript which supports the new model is being submitted for publication. The new model has been validated by the EuroSCORE Project Group and awaits validation by users worldwide. It was presented at EACTS in Lisbon on 3rd October 2011.

 

Comments 1

  1. Specifically risk associated with tricuspid valve repair/ replacement. Severe regurgitation. Patient also suffers AF. Treatment currently anticoagulants diuretiic minimal dose. Atenolol 25mg. Lung function assessment 6:40. Lung scan unremarkable.

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