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EuroSCORE predicts long-term mortality after heart valve surgery
Ioannis K Toumpoulis1, Constantine E Anagnostopoulos, Stavros K Toumpoulis
1Department of Cardiothoracic Surgery, Columbia University College of Physicians and Surgeons, St. Luke's-Roosevelt Hospital Center, New York, New York 10019, USA. toumpoul@otenet.gr
The Annals of Thoracic Surgery
|May 28, 2005
Summary
The European System for Cardiac Operative Risk Evaluation (EuroSCORE) effectively predicts long-term mortality in heart valve surgery patients. The standard EuroSCORE is a simple tool for assessing long-term survival risk.
Area of Science:
- Cardiology
- Cardiac Surgery
- Risk Stratification
Background:
- The European System for Cardiac Operative Risk Evaluation (EuroSCORE) is a widely used risk assessment tool in cardiac surgery.
- Its performance in predicting long-term mortality after heart valve surgery requires further evaluation.
Purpose of the Study:
- To assess the predictive accuracy of the EuroSCORE (standard and logistic) for long-term mortality in patients undergoing heart valve surgery.
- To determine if EuroSCORE can be utilized beyond its original scope of predicting in-hospital mortality.
Main Methods:
- Retrospective review of 1035 patients who underwent isolated or combined heart valve surgery and were discharged alive.
- Calculation of operative surgical risks using both standard and logistic EuroSCORE models.
- Long-term survival data obtained from the National Death Index with a mean follow-up of 4.5 years; Kaplan-Meier curves analyzed by EuroSCORE quartiles.
Main Results:
- Both standard and logistic EuroSCORE models demonstrated significant prediction of 5-year survival (p < 0.0001).
- Estimated 5-year survival rates decreased across EuroSCORE quartiles, with the highest-risk quartile showing significantly lower survival.
- The odds of death were substantially higher in the highest-risk quartile compared to the lowest-risk quartile (7.46-fold for standard, 7.82-fold for logistic EuroSCORE).
Conclusions:
- The EuroSCORE is a valuable tool for predicting long-term mortality in patients undergoing heart valve surgery.
- The standard EuroSCORE, due to its simplicity, is particularly suitable for predicting long-term outcomes in this patient population.
- The findings support the use of EuroSCORE for risk stratification beyond in-hospital mortality in cardiac valve surgery.
