Does EuroSCORE predict length of stay and specific postoperative complications after coronary artery bypass grafting?
BACKGROUND
To evaluate the performance of EuroSCORE in the prediction of in-hospital postoperative length of stay and specific major postoperative complications after coronary artery bypass grafting (CABG).


METHODS
Data on 3760 consecutive patients with CABG were prospectively collected. The EuroSCORE model (standard and logistic) was used to predict in-hospital mortality, prolonged length of stay (>12 days) and major postoperative complications (stroke, myocardial infarction, sternal infection, bleeding, sepsis and/or endocarditis, gastrointestinal complications, renal and respiratory failure). A C statistic (receiver operating characteristic curve) was used to test the discrimination of the EuroSCORE. The calibration of the model was assessed by the Hosmer-Lemeshow goodness-of-fit statistic.


RESULTS
In-hospital mortality was 2.7%, and 13.7% of patients had one or more major complications. EuroSCORE showed very good discriminatory ability in predicting renal failure (C statistic: 0.80) and good discriminatory ability in predicting in-hospital mortality (C statistic: 0.75), sepsis and/or endocarditis (C statistic: 0.72) and prolonged length of stay (C statistic: 0.71). There were no differences in terms of the discriminatory ability between standard and logistic EuroSCORE. Standard EuroSCORE showed good calibration (Hosmer-Lemeshow: P>0.05) in predicting these outcomes except for postoperative length of stay, while logistic EuroSCORE showed good calibration only in predicting renal failure.


CONCLUSIONS
EuroSCORE can be used to predict not only in-hospital mortality, for which it was originally designed, but also prolonged length of stay and specific postoperative complications such as renal failure and sepsis and/or endocarditis after CABG. These outcomes can be predicted accurately using the standard EuroSCORE which is very simple and easy in its calculation.
Toumpoulis
Ioannis K
IK
Columbia University College of Physicians and Surgeons, Department of Cardiothoracic Surgery, St. Luke's-Roosevelt Hospital Center, New York, NY, USA.
Anagnostopoulos
Constantine E
CE
DeRose
Joseph J
JJ
Swistel
Daniel G
DG
D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D018434:Sickness Impact Profile; D013318:Stroke Volume / Q000502:physiology; D015996:Survival Rate; D016896:Treatment Outcome