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Review
. 2009 Feb;30(3):297-304.
doi: 10.1093/eurheartj/ehn581. Epub 2009 Jan 13.

Performance of EuroSCORE in CABG and off-pump coronary artery bypass grafting: single institution experience and meta-analysis

Alessandro Parolari  1 , Lorenzo L Pesce, Matteo Trezzi, Claudia Loardi, Samer Kassem, Claudio Brambillasca, Bruno Miguel, Elena Tremoli, Paolo Biglioli, Francesco Alamanni
Affiliations
Review

Performance of EuroSCORE in CABG and off-pump coronary artery bypass grafting: single institution experience and meta-analysis

Alessandro Parolari et al. Eur Heart J. 2009 Feb.

Abstract

Aims: To assess EuroSCORE performance in predicting in-hospital mortality in on-pump coronary artery bypass grafting (CABG) and off-pump coronary artery bypass grafting (OPCAB).

Methods and results: Additive and logistic EuroSCORE were computed for consecutive patients undergoing CABG (n = 3440, 75%) or OPCAB (n = 1140, 25%) at our hospital from 1999 to September 2007. The areas under the receiver operating characteristic (ROC) curves (AUCs) were used to describe performance and accuracy. No difference in performance between CABG and OPCAB and between additive and logistic EuroSCORE (additive EuroSCORE AUCs of 0.808 and 0.779 for CABG and OPCAB, respectively; logistic EuroSCORE AUCs of 0.813 and of 0.773 for CABG and OPCAB, respectively) was found, although a marked tendency to overpredict mortality by both models was evident. A meta-analysis of previously published data was done, and a total of eight studies representing 19 212 and 5461 patients undergoing CABG and OPCAB, respectively, met inclusion criteria. Meta-analysis confirmed similar performance of EuroSCORE in CABG and OPCAB: estimated AUCs were 0.767 and 0.766 for CABG and OPCAB, respectively, with an estimated difference of 0.001 (95% CI -0.061 to 0.063).

Conclusion: Additive and logistic EuroSCORE algorithms performed similarly, and cumulative evidence suggests comparable performance in CABG and OPCAB procedures; both risk models, however, significantly overestimated mortality.

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Figures

Figure 1
Figure 1
Flow chart of the meta-analysis.
Figure 2
Figure 2
Plots of observed vs. predicted mortality rates by risk quartiles in all (A), in CABG (C), and in OPCAB (E) patients, and the ratio between observed vs. expected deaths (B, all patients; D, patients undergoing CABG; F, patients undergoing OPCAB).
See this image and copyright information in PMC

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