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. 2022 Jul;38(4):495-503.
doi: 10.6515/ACS.202207_38(4).20220128B.

Performance of the EuroSCORE II Model in Predicting Short-Term Mortality of General Cardiac Surgery: A Single-Center Study in Taiwan

Pin-Hung Liu  1 , Hsin-Hung Shih  2 , Pei-Leun Kang  1 , Jun-Yen Pan  1 , Tung-Ho Wu  1 , Chieh-Jen Wu  1
Affiliations

Performance of the EuroSCORE II Model in Predicting Short-Term Mortality of General Cardiac Surgery: A Single-Center Study in Taiwan

Pin-Hung Liu et al. Acta Cardiol Sin. 2022 Jul.

Abstract

Background: The latest European System for Cardiac Operative Risk Evaluation (EuroSCORE) II is a well-accepted risk evaluation system for mortality in cardiac surgery in Europe.

Objectives: To determine the performance of this new model in Taiwanese patients.

Methods: Between January 2012 and December 2014, 657 patients underwent cardiac surgery at our institution. The EuroSCORE II scores of all patients were determined preoperatively. The short-term surgical outcomes of 30-day and in-hospital mortality were evaluated to assess the performance of the EuroSCORE II.

Results: Of the 657 patients [192 women (29.22%); age 63.5 ± 12.68 years], the 30-day mortality rate was 5.48%, and the in-hospital mortality rate was 9.28%. The discrimination power of this new model was good in all populations, regardless of 30-day mortality or in-hospital mortality. Good accuracy was also noted in different procedures related to coronary artery bypass grafting, and good calibration was noted for cardiac procedures (p value > 0.05). When predicting surgical death within 30 days, the EuroSCORE II overestimated the risk (observed to expected: 0.79), but in-hospital mortality was underestimated (observed to expected: 1.33). The predictive ability [area under the curve (AUC) of the receiver operating characteristic (ROC) curve] and calibration of the EuroSCORE II for 30-day mortality (0.792) and in-hospital mortality (0.825) suggested that in-hospital mortality is a better endpoint for the EuroSCORE II.

Conclusions: The new EuroSCORE II model performed well in predicting short-term outcomes among patients undergoing general cardiac surgeries. For short-term outcomes, in-hospital mortality was better than 30-day mortality as an indicator of surgical results, suggesting that it may be a better endpoint for the EuroSCORE II.

Keywords: 30-day mortality; Cardiac surgery; EuroSCORE II; In-hospital mortality; Risk evaluation.

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Figures

Figure 1
Figure 1
Receiver operating characteristic curve of the 30-day mortality and in-hospital mortality. Note: The 30-day mortality AUC is 0.792 (0.710-0.875), and the in-hospital mortality AUC is 0.825 (0.768-0.882). AUC, area under the curve; ROC, receiver operating characteristic.
Figure 2
Figure 2
Comparison of the EuroSCORE II expected mortality rate with the 30-day and in-hospital mortality rates. EuroSCORE, European System for Cardiac Operative Risk Evaluation. X-axis: The score was divided into 1 to 10 groups based on the EuroSCORE II model; Y-axis: Mortality rate.
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