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The operative risk stratification models in cardiac surgery: EuroSCORE II model - risk groups categorization
- Source :
- Vojnosanitetski Pregled, Vol 77, Iss 6, Pp 607-613 (2020)
- Publication Year :
- 2020
- Publisher :
- National Library of Serbia, 2020.
-
Abstract
- Background/Aim. The treshold that defines a low, moderate or high-risk patients is not uniformly determined for the European System for Cardiac Operative Risk Evaluation (EuroSCORE II) by literature at present. The aim of this study was to suggest risk groups categorization within EuroSCORE II risk statification model. Methods. A 7,641 consecutive patients were scored preoperatively using EuroSCORE II. The end point for the study was in-hospital mortality accross the risk group categories. Patients with EuroSCORE II values of ? 2.50, > 2.50?6.50%, and > 6.50% were defined to be at low, moderate, and high perioperative risk, respectively. Discriminative power of the model was tested by calculating the area under the receiver operating characteristic curve (AUC). The calibration of the model was assessed by Hosmer-Lemeshow statistics, and with observed/expected (O/E) mortality ratio. Results. Inhospital mortality observed in our sample was 3.85% (295 out of 7,641 patients). The EuroSCORE II discriminative power was acceptable (AUCs > 0.70) for the low and high risk groups, while it failed to confirm good discrimination in the moderate risk group. Hosmer-Lemeshow statistics confirmed good calibration across risk group categories. The O/E mortality ratio failed to confirm good calibration in the low and high risk group (slight, but significant underprediction ratio of 1.24; 95% confidence interval 1.05?1.43), but confirmed good calibration in all three subcategories of the high risk group. Conclusion. The results of this study showed an acceptable overall performance of the Euro- SCORE II in terms of discrimination and accuracy of model predictions for perioperative mortality across risk group categories. Validation of EuroSCORE II performances across risk group categories needs to be further studied for a continuous improvement of patients' risk stratification before planned cardiac surgery.
- Subjects :
- hospital mortality
lcsh:R5-920
medicine.medical_specialty
business.industry
risk assessment
models, theoretical
Stratification (mathematics)
Cardiac surgery
Euroscore ii
Categorization
Internal medicine
Cardiology
medicine
risk factors
Pharmacology (medical)
Model risk
Operative risk
cardiac surgical procedures
europe
lcsh:Medicine (General)
business
Subjects
Details
- ISSN :
- 24060720 and 00428450
- Volume :
- 77
- Database :
- OpenAIRE
- Journal :
- Vojnosanitetski pregled
- Accession number :
- edsair.doi.dedup.....b9a8153b181f7f974fa0a11bf0857587