Saka Erkam, Öztürk Esin, Yüksel Aslıhan Esra, Kocabaş Nüzhet Seden
Ege University Faculty of Medicine, Department of Anaesthesiology and Reanimation, İzmir, Türkiye
Turk J Anaesthesiol Reanim. 2025 Jul 24;53(4):163-169. doi: 10.4274/TJAR.2025.241778. Epub 2025 Jul 9.
In the present study, European Cardiac Operative Risk Assessment System II (EuroSCORE II) and the Society of Thoracic Surgery (STS) risk scoring systems were used to predict mortality in patients who underwent various types of open-heart surgery, including coronary artery bypass grafting, aortic valve replacement, mitral valve replacement, and combined valve surgery with coronary artery bypass grafting, in the cardiovascular surgery operating room. The aim was to compare risk assessment systems regarding their clinical applicability.
A total of 469 patients, 141 (30.1%) female and 328 (69.9%) male, were included in the study. All risk factors were retrospectively recorded according to the EuroSCORE II and STS risk assessment systems. Statistical analysis was performed using the receiver operating characteristic (ROC) curve. Predicted and actual mortality rates were compared for each risk-scoring system.
When the ability of the EuroSCORE and STS risk classifications to predict mortality was analyzed using the ROC curve, the area under the curve for the EuroSCORE II risk score was 78.3% ( < 0.001), while the area under the curve for the STS risk score was 82.3% ( < 0.001). In our study, the STS scoring system was found to have a greater predictive value than EuroSCORE II. When the patients' observed and expected mortality rates were examined according to the EuroSCORE II and STS risk scores, no statistically significant relationship was found between the expected and observed mortality rates for each risk group.
In our study, the STS risk scoring system was found to be more accurate in predicting in-hospital mortality than the EuroSCORE. However, there was no statistically significant difference between the expected and observed mortality rates in either risk-scoring system. There is no consensus in the literature regarding which scoring system is more effective. More studies from different societies are needed.
在本研究中，使用欧洲心脏手术风险评估系统II（EuroSCORE II）和胸外科医师协会（STS）风险评分系统来预测在心血管外科手术室接受各种类型心脏直视手术（包括冠状动脉搭桥术、主动脉瓣置换术、二尖瓣置换术以及冠状动脉搭桥术联合瓣膜手术）患者的死亡率。目的是比较风险评估系统的临床适用性。
本研究共纳入469例患者，其中女性141例（30.1%），男性328例（69.9%）。所有风险因素均根据EuroSCORE II和STS风险评估系统进行回顾性记录。使用受试者工作特征（ROC）曲线进行统计分析。比较每个风险评分系统的预测死亡率和实际死亡率。
当使用ROC曲线分析EuroSCORE和STS风险分类预测死亡率的能力时，EuroSCORE II风险评分的曲线下面积为78.3%（P<0.001），而STS风险评分的曲线下面积为82.3%（P<0.001）。在我们的研究中，发现STS评分系统比EuroSCORE II具有更大的预测价值。根据EuroSCORE II和STS风险评分检查患者的观察死亡率和预期死亡率时，每个风险组的预期死亡率和观察死亡率之间未发现统计学上的显著关系。
在我们的研究中，发现STS风险评分系统在预测住院死亡率方面比EuroSCORE更准确。然而，在任何一个风险评分系统中，预期死亡率和观察死亡率之间均无统计学上的显著差异。关于哪种评分系统更有效，文献中尚无共识。需要来自不同学会的更多研究。
