Mihajlović Bogoljub, Nićin Svetozar, Kovacević Pavle, Susak Stamenko, Velicki Lazar, Kovacević Dragan, Fabri Miklos
Srp Arh Celok Lek. 2011 Jan-Feb;139(1-2):25-9. doi: 10.2298/sarh1102025m.
The European System for Cardiac Operative Risk Evaluation (EuroSCORE) was developed in order to predict operative risk in cardiac surgery and to assess the quality of the cardio-surgical care. Introduction of the uniform terminology in result evaluation process leads to the significant improvement in measuring and evaluation of surgical treatment quality.
The aim of the study was to evaluate our results in isolated coronary surgery using the EuroSCORE.
The study was done respectively by analysing predicted mortality according to the EuroSCORE model and observed operative risk in 4,675 coronary patients operated at our Clinic during the period 2001-2008. For statistical analyses, the Pearson, Chi-square and ANOVA tests were used.
The total postoperative mortality predicted by the EuroSCORE was 2.9 +/- 2.25, while the observed one was 2.2%. When the scoring system and observed results were compared over the years, a considerably lower observed mortality was found during the last 4 years. Overall average number of distal anastomoses was 2.62 +/- 0.84. During the period 2004-2008, the average number of coronary anastomoses increased over the years reaching the value of 2.77 +/- 0.88. The difference is at the level of statistical significance with the trend of further increase. Percentage of the patients with single or double graft myocardial revascularization decreases, while the number of the patients with triple or more bypasses increases.
During the last years, the results in isolated coronary surgery have considerably improved. The EuroSCORE overestimates operative risk. In order to improve its predictive value, the model should be recalibrated.
欧洲心脏手术风险评估系统(EuroSCORE)旨在预测心脏手术的手术风险并评估心脏外科护理质量。在结果评估过程中引入统一术语可显著改善手术治疗质量的测量和评估。
本研究的目的是使用EuroSCORE评估我们在单纯冠状动脉手术中的结果。
该研究分别通过根据EuroSCORE模型分析预测死亡率和观察2001年至2008年期间在我们诊所接受手术的4675例冠状动脉患者的手术风险来进行。为进行统计分析,使用了Pearson检验、卡方检验和方差分析。
EuroSCORE预测的术后总死亡率为2.9±2.25,而观察到的死亡率为2.2%。当对多年来的评分系统和观察结果进行比较时,发现过去4年观察到的死亡率明显较低。远端吻合的总体平均数量为2.62±0.84。在2004年至2008年期间,冠状动脉吻合的平均数量逐年增加,达到2.77±0.88。差异具有统计学意义且有进一步增加的趋势。单支或双支移植心肌血运重建患者的百分比下降,而三支或更多旁路患者的数量增加。
在过去几年中,单纯冠状动脉手术的结果有了显著改善。EuroSCORE高估了手术风险。为了提高其预测价值,应重新校准该模型。