Rodríguez Lima David Rene, Rodríguez Aparicio Edith Elianna, Otálora González Laura, Hernández Daniela Carolina, González-Muñoz Alejandro
Department of Critical Care, Hospital Universitario Mayor - Méderi, Bogota 111321, Colombia.
Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogota 111321, Colombia.
World J Cardiol. 2025 Mar 26;17(3):100506. doi: 10.4330/wjc.v17.i3.100506.
The EuroSCORE II is a globally accepted tool for predicting mortality in patients undergoing cardiac surgery. However, the discriminative ability of this tool in non-European populations may be inadequate, limiting its use in other regions.
To evaluate the performance of EuroSCORE II in patients undergoing coronary artery bypass graft (CABG) surgery at a hospital in Bogotá, Colombia.
An observational, analytical study of a retrospective cohort was designed. All patients admitted to Hospital Universitario Mayor Méderi who underwent CABG between December 2015 and May 2020 were included. In-hospital mortality was the primary outcome evaluated. Furthermore, the performance of EuroSCORE II was assessed in this population.
A total of 1009 patients were included [median age 66 years IQR = 59-72, 78.2% men]. The overall in-hospital mortality was 5.5% ( = 56). The median mortality predicted using EuroSCORE II was 1.29 (IQR = 0.92-2.11). Non-ST-segment elevation myocardial infarction was the most common preoperative diagnosis (54.1%), followed by ST-segment elevation myocardial infarction (19.1%) and unstable angina (14.3%). Urgent surgery was performed in 87.3% of the patients ( = 881). Mortality rates in each group were as follows: Low risk 6.0% ( = 45, observed-to-expected (O/E) ratio, 5.6), moderate risk 3.0% ( = 5, O/E ratio 1.17), high risk 5.0% ( = 4, O/E ratio 0.94), and very high risk 7.6% ( = 2, O/E ratio 0.71). The overall O/E ratio was 4.2. The area under the curve of EuroSCORE II was 0.55 [95% confidence interval: 0.48-0.63].
EuroSCORE II exhibited poor performance in this population owing to its low discriminative ability. This finding may be explained by the fact that the population comprised older individuals with higher ventricular function impairment. Moreover, unlike the population in which this tool was originally developed, most patients were not electively admitted for the surgery.
欧洲心脏手术风险评估系统II（EuroSCORE II）是全球公认的预测心脏手术患者死亡率的工具。然而，该工具在非欧洲人群中的鉴别能力可能不足，限制了其在其他地区的应用。
评估EuroSCORE II在哥伦比亚波哥大一家医院接受冠状动脉旁路移植术（CABG）的患者中的表现。
设计了一项回顾性队列的观察性分析研究。纳入2015年12月至2020年5月期间在梅德雷市长大学医院接受CABG的所有患者。住院死亡率是评估的主要结局。此外，对该人群中EuroSCORE II的表现进行了评估。
共纳入1009例患者[中位年龄66岁，四分位间距=59 - 72，男性占78.2%]。总体住院死亡率为5.5%（=56）。使用EuroSCORE II预测的中位死亡率为1.29（四分位间距=0.92 - 2.11）。非ST段抬高型心肌梗死是最常见的术前诊断（54.1%），其次是ST段抬高型心肌梗死（19.1%）和不稳定型心绞痛（14.3%）。87.3%的患者（=881）接受了急诊手术。每组的死亡率如下：低风险6.0%（=45，观察/预期（O/E）比，5.6），中度风险3.0%（=5，O/E比1.17），高风险5.0%（=4，O/E比0.94），极高风险7.6%（=2，O/E比0.71）。总体O/E比为4.2。EuroSCORE II的曲线下面积为0.55[95%置信区间：0.48 - 0.63]。
由于鉴别能力较低，EuroSCORE II在该人群中表现不佳。这一发现可能是因为该人群包括心室功能损害较高的老年个体。此外，与最初开发该工具的人群不同，大多数患者并非择期入院接受手术。
