title: Performance of EuroSCORE II in patients who have undergone heart valve surgery: a multicentre study in a Chinese population.
abstract: OBJECTIVE
  The EuroSCORE II is an updated version of the EuroSCORE. This multicentre study validated the EuroSCORE II and logistic EuroSCORE in Chinese patients who underwent heart valve surgery.
  
  
  METHODS
  A total of 11 170 adult patients underwent heart valve surgery from January 2008 to December 2011. Model discrimination and calibration were assessed for both EuroSCORE II and logistic EuroSCORE. The patients were divided into three subgroups according to the weight of the procedures, and the performance of EuroSCORE II for each group was assessed. A correlation analysis was performed for operative complications and EuroSCORE II.
  
  
  RESULTS
  The in-hospital mortality of this series was 2.02% (226 of 11 170), and the predicted mortality rate was 2.62±5.75% by EuroSCORE II and 2.55±6.51% by logistic EuroSCORE (LES). The C-statistics of EuroSCORE II and LES were 0.72 [95% confidence interval (CI) 0.69-0.75] and 0.67 (95% CI 0.63-0.70), respectively. Both models failed the Hosmer-Lemeshow goodness-of-fit test, with a P<0.05. According to the weight of the procedure, the isolated non-CABG subgroup had the best discrimination (C-statistics: 0.76 in the non-CABG group, 0.67 in the 2 procedures group and 0.73 in the 3+ procedures group). The complication ratio was strongly related to the EuroSCORE II-predicted mortality (Pearson correlation coefficient: 0.90 for ARDS, 0.97 for acute renal failure, 0.97 for prolonged ventilation and 0.94 for a prolonged ICU stay).
  
  
  CONCLUSIONS
  EuroSCORE II was an improvement upon its original logistic model for Chinese patients who underwent heart valve surgery, particularly for a single-valve procedure. The EuroSCORE II-predicted mortality correlated with the operative complications.
authors.affiliation: Department of Cardiac and Thoracic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Lv
authors.initials: L
authors.lastname: Wang
authors.forename: Qing-Qi
authors.initials: QQ
authors.lastname: Han
authors.forename: Fan
authors.initials: F
authors.lastname: Qiao
authors.forename: Chong
authors.initials: C
authors.lastname: Wang
authors.forename: Xi-Wu
authors.initials: XW
authors.lastname: Zhang
authors.forename: Lin
authors.initials: L
authors.lastname: Han
authors.forename: Zhi-Yun
authors.initials: ZY
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002681:China; D005260:Female; D006351:Heart Valves / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D055815:Young Adult
keywords: EuroSCORE; Heart valve surgery; Risk factor; Validation