title: EuroSCORE predicts mid-term outcome after combined valve and coronary bypass surgery.
abstract: OBJECTIVE
  EuroSCORE is widely used to assess operative risk. Combined cardiac procedures carry increased perioperative mortality, but the influence of preoperative factors on mid-term outcome is not well known for these patients. The study aim was to determine if EuroSCORE risk influences mid-term survival after combined coronary artery bypass grafting (CABG) and valve surgery.
  
  
  METHODS
  Follow up (mean 23.7 months) was obtained in 258 consecutive hospital survivors (148 males, 110 females; median age 72.29 years; mean EuroSCORE 7 points) operated on between January 1998 and March 2001. CABG + aortic valve replacement (AVR) was performed in 171 patients, CABG + mitral surgery in 72, and CABG + double valve surgery in 15. Kaplan-Meier estimates were calculated for survival and combined freedom from death and NYHA class III/IV. The Cox regression model was applied to prove the influence of EuroSCORE risk and a number of preoperative and operative variables on mid-term outcome.
  
  
  RESULTS
  Thirty patients (11.63%) died during follow up, and 34 (13.17%) were in NYHA class III/IV. Freedom from death and NYHA class III/IV was 89.3%, 74.7% and 55.2% at 12, 24 and 36 months, respectively. The significant predictor for combined death and NYHA class III/IV was EuroSCORE risk (p = 0.0004). In the subgroup of patients with CABG + mitral valve surgery, age was identified as a significant risk factor for death (p = 0.0346), whereas in the subgroup of patients with CABG + AVR EuroSCORE was detected as significant risk factor for combined death and NYHA class III/IV.
  
  
  CONCLUSIONS
  EuroSCORE is an important predictor for poor mid-term outcome after combined CABG and valve surgery.
authors.affiliation: Department of Cardiothoracic and Vascular Anaesthesia and Intensive Care, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors.forename: Marie-Theres
authors.initials: MT
authors.lastname: Kasimir
authors.forename: Jan
authors.initials: J
authors.lastname: Bialy
authors.forename: Reinhard
authors.initials: R
authors.lastname: Moidl
authors.forename: Natascha
authors.initials: N
authors.lastname: Simon-Kupilik
authors.forename: Martina
authors.initials: M
authors.lastname: Mittlböck
authors.forename: Michael
authors.initials: M
authors.lastname: Hiesmayr
authors.forename: Ernst
authors.initials: E
authors.lastname: Wolner
authors.forename: Paul
authors.initials: P
authors.lastname: Simon
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001026:Coronary Artery Bypass; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D020379:Risk Adjustment; D016019:Survival Analysis; D016896:Treatment Outcome