The performance of EuroSCORE II in CABG patients in relation to sex, age, and surgical risk: a nationwide study in 14,118 patients.

Autor: Silverborn M; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.; Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, SE-41345, Gothenburg, Sweden., Nielsen S; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.; Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, SE-41345, Gothenburg, Sweden., Karlsson M; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. martin.karlsson@vgregion.se.; Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, SE-41345, Gothenburg, Sweden. martin.karlsson@vgregion.se.
Jazyk: angličtina
Zdroj: Journal of cardiothoracic surgery [J Cardiothorac Surg] 2023 Jan 19; Vol. 18 (1), pp. 40. Date of Electronic Publication: 2023 Jan 19.
DOI: 10.1186/s13019-023-02141-4
Abstrakt: Background: To determine the discriminative accuracy and calibration of EuroSCORE II in relation to age, sex, and surgical risk in a large nationwide coronary artery bypass grafting (CABG) cohort.
Methods: All 14,118 patients undergoing isolated CABG in Sweden during 2012-2017 were included. Individual patient data were taken from the SWEDEHEART registry. Patients were divided by age (< 60, 60-69, 70-79, ≥ 80 years), sex, and surgical risk (low: EuroSCORE < 4%, intermediate: 4-8%, high: > 8%). Discriminative accuracy was determined by the area under the receiver operating characteristic curve (AUC) and calibration by the observed/estimated (O/E) mortality ratio at 30 days.
Results: AUC and O/E ratio were 0.82 (95% CI 0.79-0.85) and 0.58 (0.50-0.66) overall, 0.82 (0.79-0.86) and 0.57 (0.48-0.66) in men, and 0.79 (0.73-0.85) and 0.60 (0.47-0.75) in women. Regarding age, discriminative accuracy was highest in patients aged 60-69 years (AUC: 0.86 [0.80-0.93]) but was satisfactory in all groups (AUC: 0.74-0.80). O/E ratio varied from 0.26 for patients > 60 years to 0.90 for patients > 80 years. Regarding surgical risk, AUC and O/E ratio were 0.63 (0.44-0.83) and 0.18 (0.09-0.30) in low-risk patients, 0.60 (0.55-0.66) and 0.57 (0.46-0.68) in intermediate-risk patients, and 0.78 (0.73-0.83) and 0.78 (0.64-0.92) in high-risk patients.
Conclusions: EuroSCORE II had good discriminative accuracy independently of sex and age, but markedly overestimated mortality risk, especially in younger patients. Accuracy and calibration were better in high-risk patients than in low-risk and intermediate-risk patients.
(© 2023. The Author(s).)
Databáze: MEDLINE
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