EuroSCORE predicts mid-term outcome after combined valve and coronary bypass surgery.
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.
Kasimir
Marie-Theres
MT
Department of Cardiothoracic and Vascular Anaesthesia and Intensive Care, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Bialy
Jan
J
Moidl
Reinhard
R
Simon-Kupilik
Natascha
N
Mittlböck
Martina
M
Hiesmayr
Michael
M
Wolner
Ernst
E
Simon
Paul
P
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