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  • Oral presentation
  • Open Access

Performance of EuroSCORE II in the prediction of in-hospital death after on pump versus off pump CABG

  • 1,
  • 1,
  • 1,
  • 1Email author,
  • 1,
  • 1,
  • 1,
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  • 1 and
  • 1
Journal of Cardiothoracic Surgery20138(Suppl 1):O204

https://doi.org/10.1186/1749-8090-8-S1-O204

Published: 11 September 2013

Keywords

  • Predictive Ability
  • Lower Glucose
  • Distal Anastomosis
  • Complete Revascularization
  • Good Predictive Ability

Background

The role of EuroSCORE II (ES II) in risk prediction after on pump CABG X off pump (OPCAB) is unknown. Our aim was to evaluate and compare predictive power of ES II on pump X OPCAB.

Methods

All consecutive pts for CABG (Jan 2010-Dec 2012). Choice of technique was based on anatomic and clinical variables. We evaluated demographic, clinical, operative variables, ES and in-hospital outcomes. Ability of ES II was tested for performance (observed/expected [O/E] mortality ratio) and accuracy (area under the ROC curve, AUC).

Results

862 pts (63±10y, 69% male); 57% OPCAB. Median ES II=1,12%; ES I=2,45%. Observed mortality was 2,9%. OPCAB pts had lower glucose, higher ejection fraction, less previous surgeries, less LMCA lesions, smaller bleeding and less distal anastomosis (3,2±1,2 x 3,8±1,0, p<0,001). They had similar use of LITA (89,8% x 86,2%, p=0,102) and complete revascularization (94,9% x 94,5%, p=0,820). In bivariate analysis, OPCAB had lower in-hospital mortality (1,8% x 4,3%, p=0,031) and PO bleeding (1,0% x 3,0%, p=0,035), and more new revascularization (1,8% x 0%, p=0,006). Incidence of MACCE and stroke was similar. In multivariate analysis, independent predictors of death were on pump CABG (OR=3,08 [1,22-7,80] p=0,017) and ES II (OR=1,29 [1,04-1,60] p=0,023). Performance (O/E ratio) of ES II was moderate in all cohort (O/E 1,75, IC95 1,46-3,71), very good for OPCAB (O/E 1,11, IC95 1,03-1,22 ), and poor for on pump CABG (O/E 2,51, IC95 2,31-2,79), p<0,05. Accuracy: In all cohort, ES II showed fair accuracy (AUC 0,725), better than ES I (AUC 0,683). In OPCAB, accuracy was moderate (AUC 0,681), much better than ES I (AUC 0,571). In the on pump CABG, ES I and ES II showed fair accuracy (AUC 0,743 e 0,746, respectively).

Conclusions

EuroSCORE II showed moderate to good accuracy in all surgical groups. It has a better predictive ability in OPCAB than in on pump CABG. Predictive ability of ES II was better than ES I in all CABG patients.

Authors’ Affiliations

(1)
Cardiovascular Surgery, Hospital São Francisco, Porto Alegre, Brazil

Copyright

© Sales et al; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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