Clinical performances of EuroSCORE II risk stratification model in Serbian cardiac surgical population: A single centre validation study including 10,048 patients
Background/Aim. The EuroSCORE II has recently been developed with an idea to provide better accuracy in prediction of perioperative mortality in the patients who underwent open heart surgery. The aim of this study was to validate clinical performances of the European System for Cardiac Operative Ris...
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Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2019-01-01
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| Series: | Vojnosanitetski Pregled |
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| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2019/0042-84501700172N.pdf |
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| author | Nežić Duško Raguš Tatjana Mićović Slobodan Trajić Snežana Spasojević-Milin Biljana Petrović Ivana Košević Dragana Borzanović Milorad |
| author_facet | Nežić Duško Raguš Tatjana Mićović Slobodan Trajić Snežana Spasojević-Milin Biljana Petrović Ivana Košević Dragana Borzanović Milorad |
| author_sort | Nežić Duško |
| collection | DOAJ |
| description | Background/Aim. The EuroSCORE II has recently been developed with an idea to provide better accuracy in prediction of perioperative mortality in the patients who underwent open heart surgery. The aim of this study was to validate clinical performances of the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II risk stratification model in the Serbian adult cardiac surgical population undergoing open heart surgery. Methods. The Euro- SCORE II values on 10,048 consecutive patients undergoing major adult cardiac surgery from 1st January 2012 to 31st March 2017, were prospectively calculated and entered the institutional database. The 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 the Hosmer-Lemeshow (H-L) statistics and the observed to expected (O/E) mortality ratio. The patients with the EuroSCORE II values of 0.5–2.50%, > 2.50–6.50%), and > 6.50% were defined to be at low, moderate, and high perioperative risk, respectively. Results. The observed in-hospital mortality was 3.86% (388 of 10,048) and the mean predicted mortality by the Euro- SCORE II was 3.61%. The discriminatory power was very good for the entire cohort as well as for all subgroups [coronary, valve(s), combined (coronary plus valve), aortic and other] of performed cardiac procedures (all AUCs > 0.75). The H-L test confirmed good calibration only for category other cardiac procedures. The O/E mortality ratio confirmed good calibration for the whole sample [O/E ratio 1.07, 95% confidence interval (CI) 0.96–1.18] and for all subgroups of performed cardiac procedures, excluding significant underprediction of mortality for aortic surgery (O/E ratio 1.64; 95% CI 1.31–1.97). The EuroSCORE II overestimated perioperative risk in a low and underestimated perioperative risk in a high risk group, with acceptable discrimination (both AUCs = 0.72). On the contrary, the O/E mortality ratio confirmed good calibration for all three subcategories of high risk group. Conclusion. The results of our study confirmed acceptable overall performances of the EuroSCORE II risk stratification model in terms of discrimination and the accuracy of model when applied to the contemporary Serbian cardiac surgical cohort undergoing open heart surgery at our Institute. |
| format | Article |
| id | doaj-art-bcabc51ea6b843a8bb2cb0dc9be56f2c |
| institution | OA Journals |
| issn | 0042-8450 2406-0720 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade |
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| series | Vojnosanitetski Pregled |
| spelling | doaj-art-bcabc51ea6b843a8bb2cb0dc9be56f2c2025-08-20T02:18:50ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202019-01-0176880881610.2298/VSP170810172N0042-84501700172NClinical performances of EuroSCORE II risk stratification model in Serbian cardiac surgical population: A single centre validation study including 10,048 patientsNežić Duško0Raguš Tatjana1Mićović Slobodan2Trajić Snežana3Spasojević-Milin Biljana4Petrović Ivana5Košević Dragana6Borzanović Milorad7Institute for Cardiovascular Diseases “Dedinje”, Clinic of Cardiac Surgery, Department of Cardiac Surgery, Belgrade, Serbia Institute for Cardiovascular Diseases “Dedinje”, Clinic of Cardiac Surgery, Department of Cardiac Surgery, Belgrade, Serbia Institute for Cardiovascular Diseases “Dedinje”, Clinic of Cardiac Surgery, Department of Cardiac Surgery, Belgrade, Serbia Institute for Cardiovascular Diseases “Dedinje”, Clinic of Cardiac Surgery, Department of Preoperative Evaluation, Belgrade, Serbia Institute for Cardiovascular Diseases “Dedinje”, Clinic of Cardiac Surgery, Department of Preoperative Evaluation, Belgrade, Serbia Institute for Cardiovascular Diseases “Dedinje”, Clinic of Cardiac Surgery, Department of Cardiac Surgery, Belgrade, Serbia Institute for Cardiovascular Diseases “Dedinje”, Clinic of Cardiac Surgery, Department of Cardiac Surgery, Belgrade, Serbia Institute for Cardiovascular Diseases “Dedinje”, Clinic of Cardiac Surgery, Department of Preoperative Evaluation, Belgrade, Serbia Background/Aim. The EuroSCORE II has recently been developed with an idea to provide better accuracy in prediction of perioperative mortality in the patients who underwent open heart surgery. The aim of this study was to validate clinical performances of the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II risk stratification model in the Serbian adult cardiac surgical population undergoing open heart surgery. Methods. The Euro- SCORE II values on 10,048 consecutive patients undergoing major adult cardiac surgery from 1st January 2012 to 31st March 2017, were prospectively calculated and entered the institutional database. The 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 the Hosmer-Lemeshow (H-L) statistics and the observed to expected (O/E) mortality ratio. The patients with the EuroSCORE II values of 0.5–2.50%, > 2.50–6.50%), and > 6.50% were defined to be at low, moderate, and high perioperative risk, respectively. Results. The observed in-hospital mortality was 3.86% (388 of 10,048) and the mean predicted mortality by the Euro- SCORE II was 3.61%. The discriminatory power was very good for the entire cohort as well as for all subgroups [coronary, valve(s), combined (coronary plus valve), aortic and other] of performed cardiac procedures (all AUCs > 0.75). The H-L test confirmed good calibration only for category other cardiac procedures. The O/E mortality ratio confirmed good calibration for the whole sample [O/E ratio 1.07, 95% confidence interval (CI) 0.96–1.18] and for all subgroups of performed cardiac procedures, excluding significant underprediction of mortality for aortic surgery (O/E ratio 1.64; 95% CI 1.31–1.97). The EuroSCORE II overestimated perioperative risk in a low and underestimated perioperative risk in a high risk group, with acceptable discrimination (both AUCs = 0.72). On the contrary, the O/E mortality ratio confirmed good calibration for all three subcategories of high risk group. Conclusion. The results of our study confirmed acceptable overall performances of the EuroSCORE II risk stratification model in terms of discrimination and the accuracy of model when applied to the contemporary Serbian cardiac surgical cohort undergoing open heart surgery at our Institute.http://www.doiserbia.nb.rs/img/doi/0042-8450/2019/0042-84501700172N.pdfmortalitypredictive value of testsrisk assessmentthoracic surgical procedures |
| spellingShingle | Nežić Duško Raguš Tatjana Mićović Slobodan Trajić Snežana Spasojević-Milin Biljana Petrović Ivana Košević Dragana Borzanović Milorad Clinical performances of EuroSCORE II risk stratification model in Serbian cardiac surgical population: A single centre validation study including 10,048 patients Vojnosanitetski Pregled mortality predictive value of tests risk assessment thoracic surgical procedures |
| title | Clinical performances of EuroSCORE II risk stratification model in Serbian cardiac surgical population: A single centre validation study including 10,048 patients |
| title_full | Clinical performances of EuroSCORE II risk stratification model in Serbian cardiac surgical population: A single centre validation study including 10,048 patients |
| title_fullStr | Clinical performances of EuroSCORE II risk stratification model in Serbian cardiac surgical population: A single centre validation study including 10,048 patients |
| title_full_unstemmed | Clinical performances of EuroSCORE II risk stratification model in Serbian cardiac surgical population: A single centre validation study including 10,048 patients |
| title_short | Clinical performances of EuroSCORE II risk stratification model in Serbian cardiac surgical population: A single centre validation study including 10,048 patients |
| title_sort | clinical performances of euroscore ii risk stratification model in serbian cardiac surgical population a single centre validation study including 10 048 patients |
| topic | mortality predictive value of tests risk assessment thoracic surgical procedures |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2019/0042-84501700172N.pdf |
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