Assessment of left ventricular ejection fraction may invalidate the reliability of EuroSCORE

To evaluate the impact of different echocardiographic methods for assessment of left ventricular dysfunction on the predictive value of EuroSCORE and thus its reliability in daily practice and benchmarking.

Twenty-five recordings obtained by transthoracic echocardiography, optimal for study using four different echocardiographic methods, were examined and placed into relevant EuroSCORE classes. The four methods were eyeballing, Wall Motion Index, Simpson 2D volumetric method and Motion mode.

Bland and Altman plots showed that the three specific methods were not fully interchangeable. Using eyeballing as the key reference, only 44% of patients were placed in the same EuroSCORE class with all four methods. The quantitative echocardiographic methods in general overestimate the ejection fraction compared to eyeballing.

The left ventricular dysfunction factor in the EuroSCORE risk assessment system needs a more precise definition.