Assesment of the EuroSCORE as a predictor for mortality in valve cardiac surgery at the Heart Institute of Pernambuco.
OBJECTIVE
To assess the applicability of the European Risk System in Cardiac Operations (EuroSCORE) in patients undergoing cardiac valve surgery at the Heart Institute of Pernambuco.


METHODS
840 patients operated on between 2001 and 2009, who medical records contained all the informations to calculate the EuroSCORE were included in the study. Hospital death was the end-point of the study. In order to assess the applicability of the EuroSCORE it was used the non parametric test of Mann-Whitney. The calibration of the model was measured by comparing the morbidity observed with that expected, using the Hosmer-Lemeshow Test of Goodness of Fit. The accuracy of the model was evaluated by the ROC curve (receiver operating characteristic curve).


RESULTS
The comparison of expected and observed mortality, by Hosmer-Lemershow test, showed good predictive capacity (P = 0.767) as well as when compared to each value of addictive EuroSCORE (P = 0,455). The area of ROC curve was 0.731 (IC 95%, 0.660 - 0.793) with P < 0.001. The global predicted mortality was practically identical to that observed (7.9%). The low-risk group (EuroSCORE 0-2) comprised 345 patients with a mortality of 3.19%. The medium-risk group (EuroSCORE 3-5) comprised 364 patients, with a mortality of 7.69% and the high-risk group (EuroSCORE > 6) included 131 patients, with a mortality of 20.6%. The regression logistic analyses allowed to identify the following risk-factors for death: age > 60 years, gender female, previous operation, active endocarditis, associated surgery of the thoracic aorta and extra-cardiac arteriopathy.


CONCLUSIONS
The EuroSCORE, a simple and objective method, proved to be a satisfactory predictor of operative mortality and risk factors for death in patients submitted to valve cardiac operations in the Heart Institute of Pernambuco.
Andrade
Isaac Newton Guimarães
IN
Heart Institute of Pernambuco, Real Hospital Português de Beneficência em Pernambuco.
Moraes Neto
Fernando Ribeiro de
FR
Oliveira
João Paulo Segundo de Paiva
JP
Silva
Igor Tiago Correia
IT
Andrade
Tamyris Guimarães
TG
Moraes
Carlos Roberto Ribeiro de
CR
D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002300:Cardiac Care Facilities; D006348:Cardiac Surgical Procedures / Q000401:mortality*; D004812:Epidemiologic Methods; D005260:Female; D006351:Heart Valves / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment / Q000379:methods / Q000592:standards; D012307:Risk Factors; D017741:Survivors / Q000706:statistics & numerical data