title: Predicting immediate and late outcome after surgery for mitral valve regurgitation with EuroSCORE.
abstract: OBJECTIVE
  The European system for cardiac operative risk evaluation score (EuroSCORE) has been shown to be a valid tool for predicting immediate and late outcome after coronary artery bypass surgery. As evidence also suggests its value in heart valve surgery, this issue was investigated in a series of patients who underwent surgery for mitral valve regurgitation.
  
  
  METHODS
  Data obtained from 180 patients who underwent mitral valve repair (MVRep) or mitral valve replacement (MVR) were reviewed, and the patients' additive and logistic EuroSCOREs calculated.
  
  
  RESULTS
  The 30-day postoperative mortality rate was 10.0% (n = 18); rates were 7.1% after MVRep and 20.5% after MVR (p = 0.013). The additive EuroSCORE (p <0.0001, area under the ROC curve: 0.804, 95% CI 0.689-0.919, SE 0.059), as well as logistic EuroSCORE (p <0.0001, area under the ROC curve: 0.806, 95% CI 0.695-0.918, SE 0.057) were predictors of 30-day postoperative death. The 10-year overall survival rate from any cause of death was 74.7%. Additive and logistic EuroSCOREs were significantly higher in the MVR group compared to the MVRep group (p <0.0001 in both cases), and also among operative survivors. Patients who underwent MVR had a significantly poorer long-term survival than those with MVRep (p = 0.01). Both the additive EuroSCORE (p <0.0001) and logistic EuroSCORE (p = 0.003) were predictors of late, all-cause mortality. Both scores remained significant predictors of late outcome also when adjusted for type of surgery (MVRep versus MVR). Survival was particularly dismal in patients with an additive EuroSCORE >6 (at 10 years, 54.4% versus 86.6%, p <0.00001) or a logistic EuroSCORE >4% (at 10 years, 58.7% versus 86.6%, p <0.00001).
  
  
  CONCLUSIONS
  EuroSCORE is an important predictor of immediate and late outcome after surgery for mitral valve regurgitation.
authors.affiliation: Division of Cardiothoracic and Vascular Surgery, Department of Surgery, Oulu University Hospital, Oulu, Finland.
authors.forename: Jouni
authors.initials: J
authors.lastname: Heikkinen
authors.forename: Fausto
authors.initials: F
authors.lastname: Biancari
authors.forename: Jari
authors.initials: J
authors.lastname: Satta
authors.forename: Esa
authors.initials: E
authors.lastname: Salmela
authors.forename: Martti
authors.initials: M
authors.lastname: Mosorin
authors.forename: Tatu
authors.initials: T
authors.lastname: Juvonen
authors.forename: Martti
authors.initials: M
authors.lastname: Lepojärvi
mesh_terms: D000368:Aged; D005260:Female; D005387:Finland; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000401:mortality / Q000601:surgery*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012107:Research Design; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome