title: EuroSCORE and mortality in coronary artery bypass graft surgery at Pernambuco Cardiologic Emergency Medical Services [Pronto Socorro Cardiológico de Pernambuco].
abstract: OBJECTIVE
  The aim of this study is to evaluate the applicability of EuroSCORE in patients undergoing coronary artery bypass graft (CABG) surgery at the Division of Cardiovascular Surgery of Pernambuco Cardiologic Emergency Medical Services--PROCAPE.
  
  
  METHODS
  A retrospective study involving 500 patients operated between May 2007 and April 2010. The registers contained all the information used to calculate the EuroSCORE. The outcome of interest was death. Univariate analysis and multivariate analysis by backward logistic regression were applied to assess the association between each variable in the EuroSCORE and deaths. The following parameters were calculated: sensitivity, specificity, positive predictive value, and negative predictive value. The power of concordance between the predicted mortality by the EuroSCORE and the observed mortality was measured using the Kappa coefficient. The accuracy of the model was evaluated by the ROC (receiver operating characteristic) curve.
  
  
  RESULTS
  The incidence of death was 13%. In multivariate analysis, nine variables remained independent predictors of death: chronic obstructive pulmonary disease, creatinine >2,3mg/dL, active endocarditis, preoperative critical state, unstable angina, ejection fraction 30% to 50%, acute myocardial infarction < 90 days, emergency surgery and additional surgery. The score had a sensitivity of 88.4%, specificity of 79.3%, positive predictive value of 40.7%, negative predictive value of 97.7% and 80.6% concordance. The accuracy measured by the area under the ROC curve was 0.892 (95% CI 0.862-0.922).
  
  
  CONCLUSIONS
  The EuroSCORE proved to be a simple and objective index, revealing a satisfactory discriminator of postoperative evolution in patients undergoing CABG surgery at our institution.
authors.affiliation: Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, PE, Brazil. michel_pompeu@yahoo.com.br
authors.forename: Michel Pompeu Barros de Oliveira
authors.initials: MP
authors.lastname: Sá
authors.forename: Evelyn Figueira
authors.initials: EF
authors.lastname: Soares
authors.forename: Cecília Andrade
authors.initials: CA
authors.lastname: Santos
authors.forename: Omar Jacobina
authors.initials: OJ
authors.lastname: Figueredo
authors.forename: Renato Oliveira Albuquerque
authors.initials: RO
authors.lastname: Lima
authors.forename: Rodrigo Renda
authors.initials: RR
authors.lastname: Escobar
authors.forename: Frederico Pires Vasconcelos
authors.initials: FP
authors.lastname: Silva
authors.forename: Ricardo de Carvalho
authors.initials: Rde C
authors.lastname: Lima
mesh_terms: D001938:Brazil; D016507:Cardiology Service, Hospital / Q000706:statistics & numerical data; D001026:Coronary Artery Bypass / Q000401:mortality*; D004630:Emergencies; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D018570:Risk Assessment / Q000379:methods / Q000592:standards