Performance of EuroSCORE II in Predicting Early Mortality after Mitral, Aortic or Mitral & Aortic Valve Surgery Patients in National Heart Foundation Hospital and Research Institute

Bangladesh Heart Journal Pub Date : 2019-06-25 DOI:10.3329/BHJ.V34I1.41903

A. Mahmud, F. Sazzad, M. Wadud, Iftakher Raja Chowdhury, M. Rahman, Haroon Rasheed Chowdhury, Noel Cipriyan Gomes, S. Choudhury, Quamrul Islam Talukdar, P. K. Chanda, F. Ahmed

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Abstract

Background: Preoperative risk assessment before cardiac surgery to predict mortality become literally important and practicing worldwide, whereas EuroSCORE II is most updated and popular. So we examined the hypothesis that Performance of EuroSCORE II in predicting early mortality after Mitral, Aortic or mitral & aortic valve surgery patients in National Heart Foundation Hospital and Research Institute. Objectives: To compare Euro SCORE II predicted early mortality and observed early mortality in a sample of patients of National Heart Foundation Hospital who underwent for Mitral, Aortic or Mitral & Aortic valve surgery. Methods: An observational prospective study was done in Department of cardiac surgery, National Heart Foundation Hospital and Research Institute who underwent for Mitral, Aortic or Mitral & Aortic valve surgery in the period of July 2016 to March 2018. Sample size was 356 and all inclusion criteria full filled. Patients were divided into 3 group (low, medium & high) depending on the score. Model discrimination and calibration were assessed additive and logistic EuroSCORE and EuroSCORE II. Results: The in hospital mortality of this series was 2.8% (10 out of 356) and the predicted mortality was 2.73% (95% CI 1.02-4.38) by the EuroSCORE II, 2.15% (95% CI 0.68- 3.72) by the additive method and 2.25% (95% CI 0.74-3.86) by the logistic EuroSCORE. The model’s discriminatory power also good and useful as indicated by an area under ROC curve of 0.779 in EuroSCORE II model, 0.675 in additive method and 0.696 in logistic method that means EuroSCORE II method can predict the outcome with 77% accuracy, additive method with 67% accuracy and the logistic method does that with 69% accuracy. Conclusion: EuroSCORE II was validated and performed well on National Heart Foundation patients and could be recommended as a simple risk stratification system to estimate the probability of early mortality in patients scheduled for valve surgery in Bangladesh. Bangladesh Heart Journal 2019; 34(1) : 11-24

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EuroSCORE II在预测二尖瓣、主动脉瓣或二尖瓣+主动脉瓣手术患者早期死亡率中的应用

背景:心脏手术前的术前风险评估预测死亡率在世界范围内变得非常重要和实践，而EuroSCORE II是最新和最流行的。因此，我们对国家心脏基金会医院和研究所的二尖瓣、主动脉瓣或二尖瓣+主动脉瓣手术患者的早期死亡率进行了假设检验。目的:比较Euro SCORE II在国家心脏基金会医院接受二尖瓣、主动脉瓣或二尖瓣和主动脉瓣手术的患者样本中预测的早期死亡率和观察到的早期死亡率。方法:对2016年7月至2018年3月在国立心脏基金会医院心脏外科接受二尖瓣、主动脉瓣或二尖瓣+主动脉瓣手术的患者进行观察性前瞻性研究。样本量为356例，符合所有纳入标准。根据评分将患者分为低、中、高3组。对模型判别和校准进行添加剂和logistic EuroSCORE和EuroSCORE II评估。结果:该系列的住院死亡率为2.8%(356例中有10例)，EuroSCORE II预测死亡率为2.73% (95% CI 1.02-4.38)，加性法预测死亡率为2.15% (95% CI 0.68- 3.72)， logistic EuroSCORE预测死亡率为2.25% (95% CI 0.74-3.86)。EuroSCORE II模型的ROC曲线下面积为0.779，加性方法为0.675,logistic方法为0.696，表明该模型的判别能力也很好，很有用，这意味着EuroSCORE II方法预测结果的准确率为77%，加性方法为67%，logistic方法为69%。结论:EuroSCORE II在国家心脏基金会患者中得到了验证和良好的效果，可以推荐作为一个简单的风险分层系统来估计孟加拉国瓣膜手术患者的早期死亡概率。孟加拉国心脏杂志2019;34(1): 11-24

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Bangladesh Heart Journal

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