Sadeghi Mohsen Mirmohammad, Arasteh Mahfar, Gharipour Mojgan, Nilfroush Peyman, Shamsolketabi Hamid, Etesampour Ali, Sadeghi Fatemeh Mirmohammad, Kiani Amjad, Sadeghi Pouya Mirmohammad, Farahmand Niloufar
Assistant Professor of Cardiac Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2011 Jun;16(6):787-92.
This study aimed to evaluate the accuracy of Euroscore (European System for Cardiac Operative Risk Evaluation) in predicting perioperative mortality after cardiac surgery in Iranian patient population.
Data on 1362 patients undergoing coronary bypass graft surgery (CABG) from 2007 to 2009 were collected. Calibration was assessed by Hosmer-Lemeshow goodness-of-fit. Area under the curve (AUC) was used to assess score validity. Odds ratios were measured to evaluate the predictive value of each risk factor on mortality rate.
The overall perioperative in hospital mortality was 3.6% whereas the Euroscore predicted a mortality of 3.96%. Euroscore model fitted well in the validation databases. The mean AUC was 66%. Mean length of intensive care unit (ICU) stay was 2.5 ± 2.5 days. Among risk factors, only left ventricular dysfunction, age and neurologic dysfunction were found to be related to mortality rate.
Euroscore did not have acceptable discriminatory ability in perioperative in hospital mortality in Iranian patients. It seems that development of a local mortality risk scores corresponding to our patients epidemiologic characteristics may improve prediction of outcome.
本研究旨在评估欧洲心脏手术风险评估系统（Euroscore）在预测伊朗患者心脏手术后围手术期死亡率方面的准确性。
收集了2007年至2009年期间1362例行冠状动脉旁路移植术（CABG）患者的数据。通过Hosmer-Lemeshow拟合优度评估校准情况。采用曲线下面积（AUC）评估评分的有效性。测量比值比以评估各风险因素对死亡率的预测价值。
总体围手术期住院死亡率为3.6%，而Euroscore预测的死亡率为3.96%。Euroscore模型在验证数据库中拟合良好。平均AUC为66%。重症监护病房（ICU）平均住院时间为2.5±2.5天。在风险因素中，仅发现左心室功能障碍、年龄和神经功能障碍与死亡率相关。
Euroscore在预测伊朗患者围手术期住院死亡率方面没有可接受的区分能力。似乎开发与我们患者流行病学特征相对应的本地死亡率风险评分可能会改善对结果的预测。
