Prospective use of EuroSCORE for the short-term risk evaluation of consecutive cardiac surgery candidates: are there any differences in prediction of perioperative risk versus risk of nonsurgical treatments?

BACKGROUND: In the era of modern medicine, the relevance of perioperative risk stratification with respect to the practice of cardiac surgeons and cardiologists worldwide has increased. AIM: This study aims at estimating the validity of a preoperative risk stratification model EuroSCORE in predicting short-term mortality in Czech adult cardiac population. METHODS: All consecutive patients (n = 460) presented to cardiac surgeons as surgery candidates during a six-month period were enrolled in this study. The Additive and logistic EuroSCORE were used for the risk assessment. The operative mortality, as well as the mortality within 30 days from discharge were recorded. The observed and predicted mortality derived from the EuroSCORE were compared. RESULTS: Fifty-seven percent of the patients underwent cardiac surgery, while 43% was refused for surgery by the cardiac surgeon. There was no significant difference between the observed and predicted mortality in both subgroups. EuroSCORE showed good discriminatory ability in predicting short-term mortality (C statistic 0.755 vs. 0.762 for the surgery subgroup and 0.695 vs. 0.716 for the refused subgroup). CONCLUSIONS: The EuroSCORE has a good discriminatory ability in predicting early mortality after cardiac surgery as well as in patients rejected for cardiac surgery. Both EuroSCORE risk prediction model forms are a suitable mortality predictor in Czech cardiac patients.