External validation of European system for cardiac operative risk evaluation II (EuroSCORE II) for risk prioritization in an Iranian population

Atashi, A. and Amini, S. and Tashnizi, M. A. and Moeinipour, A. A. and Aazami, M. H. and Tohidnezhad, F. and Ghasemi, E. and Eslami, S. (2018) External validation of European system for cardiac operative risk evaluation II (EuroSCORE II) for risk prioritization in an Iranian population. Brazilian Journal of Cardiovascular Surgery, 33 (1). pp. 40-46.

[img] Text
External validation of European system for cardiac operative risk evaluation II (EuroSCORE II) for risk prioritization in an Iranian population.pdf

Download (162kB)

Abstract

Introduction: The European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) is a prediction model which maps 18 predictors to a 30-day post-operative risk of death concentrating on accurate stratification of candidate patients for cardiac surgery. Objective: The objective of this study was to determine the performance of the EuroSCORE II risk-analysis predictions among patients who underwent heart surgeries in one area of Iran. Methods: A retrospective cohort study was conducted to collect the required variables for all consecutive patients who underwent heart surgeries at Emam Reza hospital, Northeast Iran between 2014 and 2015. Univariate and multivariate analysis were performed to identify covariates which significantly contribute to higher EuroSCORE II in our population. External validation was performed by comparing the real and expected mortality using area under the receiver operating characteristic curve (AUC) for discrimination assessment. Also, Brier Score and Hosmer-Lemeshow goodness-of-fit test were used to show the overall performance and calibration level, respectively. Results: Two thousand five hundred eight one (59.6 males) were included. The observed mortality rate was 3.3, but EuroSCORE II had a prediction of 4.7. Although the overall performance was acceptable (Brier score=0.047), the model showed poor discriminatory power by AUC=0.667 (sensitivity=61.90, and specificity=66.24) and calibration (Hosmer-Lemeshow test, P<0.01). Conclusion: Our study showed that the EuroSCORE II discrimination power is less than optimal for outcome prediction and less accurate for resource allocation programs. It highlights the need for recalibration of this risk stratification tool aiming to improve post cardiac surgery outcome predictions in Iran. © 2018, Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved.

Item Type: Article
Additional Information: Cited By :4 Export Date: 16 February 2020 Correspondence Address: Amini, S.; Department of Anesthesiology and Critical Care, Cardiac Anesthesia Research Center, Emam Rreza Hospital, Ebne Sina Street, Iran; email: aminish@mums.ac.ir
Uncontrolled Keywords: Cardiac surgical procedures Decision support techniques Mortality Risk assessment adult article calibration cohort analysis decision support system EuroSCORE female heart surgery human Iran Iranian (citizen) male mortality rate multivariate analysis prediction receiver operating characteristic resource allocation retrospective study stratification validation process adolescent aged middle aged procedures prognosis validation study very elderly young adult Aged, 80 and over Cohort Studies Humans Retrospective Studies ROC Curve
Subjects: WG Cardiovascular System
WO Surgery
Divisions: Mashhad University of Medical Sciences
Depositing User: lib2 lib2 lib2
Date Deposited: 08 Jun 2020 04:46
Last Modified: 08 Jun 2020 04:46
URI: http://eprints.mums.ac.ir/id/eprint/17213

Actions (login required)

View Item View Item