Performance of the original EuroSCORE

Area of Science:

• Cardiology
• Health Services Research

Background:

• The European system for cardiac operative risk evaluation (EuroSCORE) is widely utilized for predicting operative mortality in cardiac surgery.
• Assessing the accuracy of risk prediction models is crucial for clinical decision-making and healthcare management.

Purpose of the Study:

• To systematically review and evaluate the performance of the additive and logistic EuroSCORE models.
• To determine the accuracy and reliability of EuroSCORE in predicting operative mortality across diverse patient populations.

Main Methods:

• A systematic literature search was conducted, identifying 67 relevant articles.
• Studies included patients undergoing cardiac surgery with reported early mortality data.
• Weighted meta-regression analysis was employed to assess model performance.

Main Results:

• The EuroSCORE, particularly the additive model, demonstrated a tendency to overestimate cardiac surgery mortality.
• Performance varied significantly based on patient risk profiles; high-risk patients experienced underestimation by the additive model.
• The discriminative ability of the EuroSCORE was found to be good.

Conclusions:

• The overall predictive performance of the EuroSCORE raises concerns about its suitability for patient selection and benchmarking.
• Clinical application of EuroSCORE requires careful consideration of its limitations and performance variations.
• Further research may be needed to refine risk prediction models in cardiac surgery.