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[Mortality risk estimation in cardiac surgery].

Michele Danilo Pierri1, Mauro Borioni, Gianfranco Iacobone

  • 1Divisione di Cardiochirurgia, Istituo Cardiologico G. M. Lancisi, Ancona. micheledpierri@yahoo.it

Italian Heart Journal. Supplement : Official Journal of the Italian Federation of Cardiology
|April 15, 2004
PubMed
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The Society of Thoracic Surgeons (STS) and Northern New England (NE) risk scores accurately predict cardiac surgery mortality, while the EuroSCORE (ES) tends to overestimate it.

Area of Science:

  • Cardiovascular Surgery
  • Medical Statistics
  • Health Outcomes Research

Background:

  • Predicting operative mortality after cardiac surgery is crucial for patient management and risk stratification.
  • Existing risk models require validation in diverse patient populations and surgical contexts.

Purpose of the Study:

  • To evaluate and compare the predictive accuracy of three established risk models for operative mortality in cardiac surgery patients.
  • To assess the performance of the Society of Thoracic Surgeons (STS) risk score, EuroSCORE (ES), and Northern New England Cardiovascular Disease Study Group (NE) score.

Main Methods:

  • A retrospective analysis of 3111 cardiac surgery patients from an Italian institutional database.
  • Risk factors were collected, and predicted mortality was calculated using STS, ES, and NE scores.

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  • Model performance was assessed using Receiver Operating Characteristic (ROC) curves.

    • Main Results:

    • Observed mortality in the myocardial revascularization cohort was 2.2%.
    • Mean predicted mortality rates were 1.9% (STS), 4.2% (ES), and 1.9% (NE).
    • ROC curves indicated good predictive ability for all models (0.82 for STS, 0.77 for ES, 0.78 for NE).

    Conclusions:

    • All three risk models demonstrated acceptable accuracy in predicting operative mortality after cardiac surgery.
    • The EuroSCORE (ES) consistently overestimated mortality across all risk levels.
    • STS and NE scores showed comparable and reliable performance in this patient cohort.