Long-term survival after coronary artery bypass surgery stratified by EuroSCORE.
OBJECTIVE
Coronary artery bypass grafting (CABG) is performed for symptoms and for prognostic reasons. The EuroSCORE is widely utilized as a pre-operative risk prediction tool. We evaluated our long-term survival figures based on EuroSCORE.


METHODS
A prospective database was retrospectively analysed and cross correlated with the UK strategic tracking service to evaluate survival after primary CABG. Patients were grouped based on their logistic EuroSCORE 0 to <5, 5 to <10, 10 to <15, 15 to <20, 20 to <25 and ≥25.


RESULTS
We analysed 13,337 primary cardiac procedures. A total of 9961 procedures had a logistic EuroSCORE of 0 to <5, 2041 of 5 to <10, 636 of 10 to <15, 281 of 15 to <20, 137 of 20 to <25 and 281≥25. Long-term survival is significantly affected by logistic EuroSCORE, P < 0.001. Patients with a logistic EuroSCORE <5% had significantly better initial survival and a lower rate of death over a 10-year period, P<0.001. Patients with a logistic score over 25 had a significantly worse 5-year survival, P<0.001. Logistic EuroSCORE was poor at predicting survival when >5 and <25. Cox multivariate regression and neuronal network analysis confirmed that the additional factors, diabetes, body mass index (BMI), post-operative myocardial creatinine kinase myocardial isoenzyme (CKMB) and left internal mammary artery (LIMA) usage, which are not incorporated in EuroSCORE significantly predict long-term survival.


CONCLUSIONS
Logistic EuroSCORE is a reasonable approximation for long-term survival after CABG, if the score is <5; however, its predictive capacity is limited due to the absence of LIMA usage, BMI, diabetes and CKMB in its calculation, all of which are significant factors affecting long-term survival.
Department of Cardiac Surgery,  Liverpool Heart and Chest Hospital, Liverpool,  UK.
Francesca
F
O'Boyle
Neeraj
N
Mediratta
Brian
B
Fabri
Mark
M
Pullan
John
J
Chalmers
James
J
McShane
Mathew
M
Shaw
Michael
M
Poullis
D000368:Aged; D000369:Aged, 80 and over; D019985:Benchmarking; D001026:Coronary Artery Bypass / Q000401:mortality* / Q000592:standards; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016571:Neural Networks, Computer; D012372:ROC Curve; D012189:Retrospective Studies; D020379:Risk Adjustment; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome