1. Validation study of EuroSCORE II for dialysis patients: A single-center study in Japan.
- Author
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Sueda, Keishiro, Hiraoka, Eiji, Kitamura, Koichi, Norisue, Yasuhiro, Suzuki, Toshihiko, Takahashi, Osamu, Ito, Joji, and Tabata, Minoru
- Abstract
The European System for Cardiac Operative Risk Evaluation (EuroSCORE) II is a predictive model for in-hospital mortality after cardiac surgery. Although it has good performance among the general population undergoing cardiac surgery, it has not been validated among dialysis patients, who have a higher rate of mortality after cardiac surgery. This study aimed to evaluate the performance of the model in predicting in-hospital mortality in maintenance dialysis patients undergoing cardiac surgery. This retrospective, single-center study included adult patients on maintenance dialysis who underwent open cardiac surgery at our institution. Calibration performance of EuroSCORE II for in-hospital death was determined based on the comparison between expected and observed mortalities for low- (EuroSCORE II <4 %), intermediate- (4–8 %), and high-risk (>8 %) groups. The area under receiver operating characteristic curve (AUROC) was investigated to determine the model's discrimination performance. A total of 163 patients (male, 73.6 %; median age, 70 years; median dialysis vintage, 9 years; median EuroSCORE II, 3.3 %) were included. The mortality rate was 9.2 %. The observed mortality rates (vs. mean expected mortality) rates were 2.1 % (vs. 2.4 %), 7.5 % (vs. 5.5 %), and 34.5 % (vs. 21.1 %) in the low-, intermediate-, and high-risk groups, respectively. Its AUROC was 0.825 (95 % confidence interval, 0.711–0.940). Although EuroSCORE II model adequately estimated in-hospital mortality in the low-and intermediate-risk groups (EuroSCORE II <8 %), it underestimated in-hospital mortality in the high-risk group (EuroSCORE II >8 %) among maintenance dialysis patients. The discrimination performance of the model for in-hospital death was good among maintenance dialysis patients. [Display omitted] • Dialysis patients undergoing cardiac surgery have high surgical risk. • The study aimed to investigate the validity of EuroSCORE II for the population. • Good discrimination performance of in-hospital death among dialysis patients • Adequate performance in estimating in-hospital death in cases of EuroSCORE II <8 % • Underestimation of in-hospital mortality in cases with EuroSCORE II >8 % [ABSTRACT FROM AUTHOR]
- Published
- 2024
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