title: Performance of EuroSCORE in CABG and off-pump coronary artery bypass grafting: single institution experience and meta-analysis.
abstract: OBJECTIVE
  To assess EuroSCORE performance in predicting in-hospital mortality in on-pump coronary artery bypass grafting (CABG) and off-pump coronary artery bypass grafting (OPCAB).
  
  
  RESULTS
  Additive and logistic EuroSCORE were computed for consecutive patients undergoing CABG (n = 3440, 75%) or OPCAB (n = 1140, 25%) at our hospital from 1999 to September 2007. The areas under the receiver operating characteristic (ROC) curves (AUCs) were used to describe performance and accuracy. No difference in performance between CABG and OPCAB and between additive and logistic EuroSCORE (additive EuroSCORE AUCs of 0.808 and 0.779 for CABG and OPCAB, respectively; logistic EuroSCORE AUCs of 0.813 and of 0.773 for CABG and OPCAB, respectively) was found, although a marked tendency to overpredict mortality by both models was evident. A meta-analysis of previously published data was done, and a total of eight studies representing 19 212 and 5461 patients undergoing CABG and OPCAB, respectively, met inclusion criteria. Meta-analysis confirmed similar performance of EuroSCORE in CABG and OPCAB: estimated AUCs were 0.767 and 0.766 for CABG and OPCAB, respectively, with an estimated difference of 0.001 (95% CI -0.061 to 0.063).
  
  
  CONCLUSIONS
  Additive and logistic EuroSCORE algorithms performed similarly, and cumulative evidence suggests comparable performance in CABG and OPCAB procedures; both risk models, however, significantly overestimated mortality.
authors.affiliation: Department of Cardiac Surgery, Unit for Clinical Research in Atherothrombosis, Centro Cardiologico Monzino IRCCS, University of Milan, Via Parea, 4, 20138 Milan, Italy. alessandro.parolari@cardiologicomonzino.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Parolari
authors.forename: Lorenzo L
authors.initials: LL
authors.lastname: Pesce
authors.forename: Matteo
authors.initials: M
authors.lastname: Trezzi
authors.forename: Claudia
authors.initials: C
authors.lastname: Loardi
authors.forename: Samer
authors.initials: S
authors.lastname: Kassem
authors.forename: Claudio
authors.initials: C
authors.lastname: Brambillasca
authors.forename: Bruno
authors.initials: B
authors.lastname: Miguel
authors.forename: Elena
authors.initials: E
authors.lastname: Tremoli
authors.forename: Paolo
authors.initials: P
authors.lastname: Biglioli
authors.forename: Francesco
authors.initials: F
authors.lastname: Alamanni
mesh_terms: D000368:Aged; D002315:Cardiopulmonary Bypass / Q000401:mortality; D001026:Coronary Artery Bypass / Q000401:mortality*; D047549:Coronary Artery Bypass, Off-Pump / Q000401:mortality; D003327:Coronary Disease / Q000401:mortality / Q000601:surgery*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis