David Rene Rodríguez Lima, Edith Elianna Rodríguez Aparicio, Laura Otálora González, Daniela Carolina Hernández, Alejandro González-Muñoz
{"title":"在中等收入国家哥伦比亚，EuroSCORE在冠状动脉搭桥术中的表现：一个回顾性队列。","authors":"David Rene Rodríguez Lima, Edith Elianna Rodríguez Aparicio, Laura Otálora González, Daniela Carolina Hernández, Alejandro González-Muñoz","doi":"10.4330/wjc.v17.i3.100506","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Aim: </strong>To evaluate the performance of EuroSCORE II in patients undergoing coronary artery bypass graft (CABG) surgery at a hospital in Bogotá, Colombia.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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% (<i>n</i> = 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 (<i>n</i> = 881). Mortality rates in each group were as follows: Low risk 6.0% (<i>n</i> = 45, observed-to-expected (O/E) ratio, 5.6), moderate risk 3.0% (<i>n</i> = 5, O/E ratio 1.17), high risk 5.0% (<i>n</i> = 4, O/E ratio 0.94), and very high risk 7.6% (<i>n</i> = 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].</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 3","pages":"100506"},"PeriodicalIF":1.9000,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947952/pdf/","citationCount":"0","resultStr":"{\"title\":\"Performance of the EuroSCORE in coronary artery bypass graft in Colombia, a middle-income country: A retrospective cohort.\",\"authors\":\"David Rene Rodríguez Lima, Edith Elianna Rodríguez Aparicio, Laura Otálora González, Daniela Carolina Hernández, Alejandro González-Muñoz\",\"doi\":\"10.4330/wjc.v17.i3.100506\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Aim: </strong>To evaluate the performance of EuroSCORE II in patients undergoing coronary artery bypass graft (CABG) surgery at a hospital in Bogotá, Colombia.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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% (<i>n</i> = 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 (<i>n</i> = 881). Mortality rates in each group were as follows: Low risk 6.0% (<i>n</i> = 45, observed-to-expected (O/E) ratio, 5.6), moderate risk 3.0% (<i>n</i> = 5, O/E ratio 1.17), high risk 5.0% (<i>n</i> = 4, O/E ratio 0.94), and very high risk 7.6% (<i>n</i> = 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].</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":23800,\"journal\":{\"name\":\"World Journal of Cardiology\",\"volume\":\"17 3\",\"pages\":\"100506\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-03-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947952/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Cardiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4330/wjc.v17.i3.100506\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Cardiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4330/wjc.v17.i3.100506","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Performance of the EuroSCORE in coronary artery bypass graft in Colombia, a middle-income country: A retrospective cohort.
Background: 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.
Aim: To evaluate the performance of EuroSCORE II in patients undergoing coronary artery bypass graft (CABG) surgery at a hospital in Bogotá, Colombia.
Methods: 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.
Results: 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% (n = 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 (n = 881). Mortality rates in each group were as follows: Low risk 6.0% (n = 45, observed-to-expected (O/E) ratio, 5.6), moderate risk 3.0% (n = 5, O/E ratio 1.17), high risk 5.0% (n = 4, O/E ratio 0.94), and very high risk 7.6% (n = 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].
Conclusion: 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.
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