Background. This is a validation study comparing the European System for Cardiac Operative Risk Evaluation
(EuroSCORE) II with the previous additive (AES) and logistic EuroSCORE (LES) and the Society of Thoracic Surgeons’
(STS) risk prediction algorithm, for patients undergoing valve replacement with or without bypass in Pakistan.
Patients and Methods. Clinical data of 576 patients undergoing valve replacement surgery between 2006 and
2013 were retrospectively collected and individual expected risks of death were calculated by all four risk prediction
algorithms. Performance of these risk algorithms was evaluated in terms of discrimination and calibration.
Results. There were 28 deaths (4.8%) among 576 patients, which was lower than the predicted mortality of 5.16%,
6.96% and 4.94% by AES, LES and EuroSCORE II but was higher than 2.13% predicted by STS scoring system. For
single and double valve replacement procedures, EuroSCORE II was the best predictor of mortality with highest
Hosmer and Lemmeshow test (H-L) p value (0.346 to 0.689) and area under the receiver operating characteristic
(ROC) curve (0.637 to 0.898). For valve plus concomitant coronary artery bypass grafting (CABG) patients actual
mortality was 1.88%. STS calculator came out to be the best predictor of mortality for this subgroup with H-L
p value (0.480 to 0.884) and ROC (0.657 to 0.775).
Conclusions. For Pakistani population EuroSCORE II is an accurate predictor for individual operative risk in
patients undergoing isolated valve surgery, whereas STS performs better in the valve plus CABG group.
Aortic, EuroSCORE, Mitral, Pakistan, Society of Thoracic Surgeons, Valve
Financial support: None of the authors has financial interest related
to this study to disclose.
Hasanat Sharif Department of Cardiothoracic Surgery Private wing 2nd floor Aga Khan University Hospital Karachi 74800, Pakistan firstname.lastname@example.org
Share this Article
Related Content In Interventional Cardiology
Foreword – Heart International. 2020;14(2):66
Welcome to the latest edition of Heart International. I would like to begin by paying tribute to all the victims of the coronavirus pandemic. I know of very few people who have not lost a family member, friend, colleague or a neighbour with COVID-19. Such deaths are not simply statistics, for behind each death is a […]
A Review of Bleeding Risk with Impella-supported High-risk Percutaneous Coronary Intervention
Heart International. 2020;14(2):92-99 DOI: https://doi.org/10.17925/HI.2020.14.2.92
Percutaneous coronary intervention (PCI) has evolved over recent years, with increasingly more complex, high-risk procedures being performed, including in patients with multivessel coronary artery disease with or without left main disease, often complicated by severe left ventricular (LV) dysfunction.1 In addition, decisions about coronary bypass surgery or PCI often focus not only on coronary anatomy, […]
Summary of Practice Considerations for Percutaneous Coronary Intervention of Left Main Bifurcation Disease
Heart International. 2020;14(2):69-72 DOI: https://doi.org/10.17925/HI.2020.14.2.69
Technical approaches to left main (LM) revascularisation by percutaneous techniques continues to be in evolution. This manuscript will attempt to summarise the current best practices for LM percutaneous coronary intervention (PCI). Following a clinical decision for PCI of left main bifurcation (LMB) stenosis, based on angiographic, imaging and functional severity, and supported by current guidelines […]
Journal articles and more to your inbox
Get the latest clinical insights from touchCARDIOSign me up!