title: [EuroSCORE underestimate the mortality risk in cardiac valve surgery of Mexican population].
abstract: OBJECTIVE
  The EuroSCORE (European System for cardiac operative risk evaluation) stratifies cardiac risk surgery in easy and accessible manner; it was validated in North America with good results but in many countries of Latin America is used routinely without prior validation. Our objective was to validate the EuroSCORE in patients with cardiac valve surgery at the Instituto Nacional de Cardiología Ignacio Chávez (INCICh) in México.
  
  
  METHODS
  EuroSCORE additive and logistic models were used to predict mortality in adults undergoing cardiac valve surgery from march 2004 to march 2008. The goodness of fit test of Hosmer-Lemeshow was used to evaluate the calibration. The area under the ROC curve was calculated to determinate discrimination.
  
  
  RESULTS
  We included 1188 patients with ages of 51.3±14.5 years, 52% women. There were significant differences in the prevalence of risk factors among the INCICh and the EuroSCORE populations. Total mortality was 9.68% versus 5% and 5.6% predicted by additive and logistic EuroSCORE. According to additive EuroSCORE the risk was low in 11.3%, intermediate in 52.9% and high in 35.9%; for these groups the mortality was .7%, 6.34% and 17.4% against those predicted of 2%, 3.9% and 7.64%. Hosmer-Lemeshow test had a P<.001 for both models and the area under the ROC curve was .707 and .694 for additive and logistic EuroSCORE.
  
  
  CONCLUSIONS
  In the INCICh 88.7% of patients with cardiac valve surgery had intermediate to high risk and EuroSCORE underestimated the risk of mortality.
authors: Consulta Externa, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México. Electronic address: lauraleticiar@gmail.com.
authors: Laura L
authors: LL
authors: Rodríguez-Chávez
authors: Terapia Posquirúrgica, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México.
authors: Javier
authors: J
authors: Figueroa-Solano
authors: Consulta Externa, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México.
authors: Carlos E
authors: CE
authors: Muñoz-Consuegra
authors: Ecocardiografía, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México.
authors: Nydia
authors: N
authors: Avila-Vanzzini
authors: Consulta Externa, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México.
authors: Jorge
authors: J
authors: Kuri-Alfaro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000401:mortality; D005260:Female; D006349:Heart Valve Diseases / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008800:Mexico; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D055815:Young Adult
keywords: Cirugía valvular; EuroSCORE; External validation; México; Riesgo quirúrgico; Risk surgery; Validación externa; Valve surgery