Comparison of two risk stratification models in elective coronary artery bypass patients

To compare the Cleveland Clinical Score and EuroSCORE when evaluating patients submitted to elective CABGS in Rio Grande do Sul, RS, Brazil. METHODS; This was a cohort study of 202 patients given CABGS between January 2006 and March 2007. Surgical risk was categorized according to the Cleveland Clinic Score and the EuroSCORE as low, medium or high. The incidence of deaths was measured over a 60-day period.

The mean age of patients was 62 ± 10 years and 134 (66%) of them were men. A correlation was observed between the scores for classifying patients into different levels of risk. According to the Cleveland Clinic score and the EuroSCORE, respectively, patients were categorized as follows: 142(70.3%) and 155(76.7%) low risk patients, 56(27.7%) and 43(21.3) intermediate risk patients and 4(2%) and 4(2%) high risk patients; with a Kaplan correlation coefficient of 0.432; p0.001. Thirteen (13, 6.4%) patients died during the first 60 days after surgery. There was a correlation between greater incidence of death and higher risk categories for both the Cleveland Clinic score and the EuroSCORE. Deaths occurred in the Cleveland and EuroSCORE risk groups, respectively, as follows: 6 (4.4%) and 7 (4.5%) in the low risk group; 5 (8.9%) and 5 (11.6%) in the intermediate risk group and 2 (50%) 3 1(25%) in the high risk group. Observed sensitivity for surgical mortality prediction was 72.5% and 66.5% for the Cleveland score and EuroSCORE respectively.

The Cleveland Clinic and EuroSCORE surgical risk prediction instruments are both moderately effective for predicting mortality among elective CABGS patients.