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find Keyword "EuroSCORE" 5 results
  • Application and Prospect of EuroSCORE and SinoSCORE for the Prediction of Mortality after Cardiovascular Surgery in Adults

    With significantly increasing proportion of high-risk patients undergoing cardiovascular surgery, a quantitative risk stratification system of perioperative patients is needed for cardiovascular surgeons. European system for cardiac operative risk evaluation (EuroSCORE) is a widely-used risk prediction model for adult patients undergoing cardiovascular surgery in the world. Research data from Chinese Cardiac Surgery Registry show that the performance of EuroSCORE in the prediction of postoperative risk of Chinese cardiovascular surgical patients is not satisfactory. Thus, the first Chinese coronary operative risk evaluation model (Sino system for coronary operative risk evaluation,SinoSCORE) is established with latest cardiovascular surgery data by Collaboration Association of Cardiovascular Surgeon in China, and has been widely used in clinical practice. This review focuses on the application and prospect of EuroSCORE and SinoSCORE for the prediction of mortality after cardiovascular surgery in adults.

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  • Review and Prospect of Clinical Application of EuroSCORE

    European system for cardiac operative risk evaluation(EuroSCORE) is one of the widely used and influential cardiac surgery risk assessment system. It was originally used to predict the quantitative score of probability of death after cardiac surgery. After that, it has been developed to predict long-term mortality and survival rate, ICU residence time, treatment costs, main complications and so on. EuroSCORE Ⅱ is the latest version, which is more accurate in predicting mortality, long term survival rate than the old one. But there are also some limitations as predicting limited range of the end, underestimating the mortality of critically endangered patients, lacking adequate preoperative risk factors and so on. This review article focuses on the production, development and clinical application of EuroSCORE.

    Release date:2016-10-19 09:15 Export PDF Favorites Scan
  • The early and midterm clinical outcomes of mitral valvuloplasty versus replacement for infective endocarditis: A propensity score matching study

    ObjectiveTo compare the clinical outcomes of mitral valvuloplasty (MVP) and mitral valve replacement (MVR) for infective endocarditis, and to investigate the effect of MVP under different surgical risks. MethodsA retrospective study was done on the patients with mitral infective endocarditis, who underwent surgical treatment in our department from January 2018 to March 2022. Among them, the patients receiving mitral valve repair were divided into a MVP group, and the patients receiving mitral valve replacement were divided into a MVR group. Propensity score matching method was applied with a ratio of 1∶1 to eliminate the biases. The early and midterm outcomes were compared between the two groups after matching. According to the European System for Cardiac Operative Risk Evaluation Ⅱ(EuroSCORE-Ⅱ), the effect of MVP was compared between high and low risk patients. ResultsA total of 195 patients were collected. There were 141 patients in the MVP group (102 males, 85.1%) and 54 patients in the MVR group (41 males, 75.9%). Patients in the MVP group were younger (43.0±14.6 years vs. 57.0±13.0, P<0.001) and had better preoperative conditions. The mean follow-up time was 30.4±16.1 months. The patients in the MVP group had a shorter ICU stay (5.0±5.4 d vs. 7.0±7.0 d, P=0.037), and lower incidences of low cardiac output syndrome (0.7% vs. 9.3%, P=0.007), in-hospital mortality (0.0% vs. 3.7%, P=0.023), and follow-up mortality (4.3% vs. 15.4%, P=0.007). However, after 1∶1 propensity score matching, there were no statistical differences in the postoperative and follow-up adverse events between the two groups (P>0.05). Also, there was no statistical difference in the mortality of high-risk patients between MVP and MVR group (P>0.05). There was no statistical difference in the reoperation and recurrent severe mitral regurgitation between high and low-risk patients in the MVP group (P>0.05). Conclusion MVP is feasible for treating mitral lesions caused by infective endocarditis with good early and midterm outcomes. For patients who have severe preoperative conditions without serious valvular lesions, surgeons could try MVP.

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  • EuroSCORE模型对心瓣膜手术患者死亡风险的预测

    目的 评价欧洲心脏手术风险评估系统(European System for Cardiac Operative Risk Evaluation,EuroSCORE)模型预测行心脏瓣膜手术患者在院死亡率的准确性。 方法 收集1998年1月至2008年12月于第二军医大学长海医院因心脏瓣膜疾病行外科治疗4 155例患者的临床资料,其中男1 955例,女2 200例;年龄45.90±13.64岁。先按additive及 logistic uroSCORE两种方法评分,将患者分为低风险(n=981)、中风险(n=2 492)、高风险(n=682)3个亚组,比较全组及各亚组患者的实际与预测死亡率。模型预测的校准度用HosmerLemeshow卡方检验,预测的鉴别度采用受试者工作特征(receiver operating characteristic,ROC)曲线下面积检验。 结果  4 155例患者在院死亡205例,实际在院死亡率4.93%;additive EuroSCORE预测死亡率为3.80%,而logistic EuroSCORE为3.30%;提示两种评分方法均低估了实际在院死亡率(χ2=11.13, 44.34,Plt;0.05)。additive EuroSCORE对高风险亚组在院死亡预测校准度较高(χ2=361,P=0.31),但对低风险亚组(χ2=0.00,Plt;0.01)及中风险亚组(χ2=14.72,Plt;0.01)较低;而logistic EuroSCORE对低风险亚组(χ2=1.66,P=0.88)及高风险亚组(χ2=11.71,P=0.11)在院死亡预测准确性均较高,却低估了中风险亚组(χ2=17.48,Plt;0.01)的实际在院死亡率。两种评分方法对全组患者在院死亡预测的鉴别度均较差(ROC曲线下面积分别为0.676和0.677)。 结论 EuroSCORE模型对本中心心瓣膜手术患者死亡风险预测的准确性较差,不适合本中心心瓣膜手术的风险预测,在今后的临床实践中应慎重使用。

    Release date:2016-08-30 05:57 Export PDF Favorites Scan
  • Validation of European System for Cardiac Operative Risk Evaluation Ⅱ in Predicting the Mortality and Prolonged Intensive Care Unit Stay after Sun's Procedure for Stanford type A Aortic Dissection

    ObjectiveTo evaluate the validity of European System for Cardiac Operative Risk Evaluation (EuroSCORE) Ⅱ for predicting in-hospital mortality and prolonged ICU stay after Sun's procedure (total aortic arch replacement with stented elephant trunk implantation) for Stanford type A aortic dissection (STAAD). MethodsClinical data of 384 STAAD patients undergoing Sun's procedure in Beijing Anzhen Hospital between February 2009 and February 2012 were retrospectively analyzed, including 228 (59.38%) patients with acute STAAD. Accoding to EuroSCORE Ⅱ to predict postoperative mortality, all the patients were divided into a low-risk group, a medium-risk group, a high-risk group and an extremely-high-risk group. There were 296 patients including 52 females in the low-risk group with their age of 45.39±10.75 years, 70 patients including 19 females in the medium-risk group with their age of 47.67±11.26 years, 13 patients including 5 females in the high-risk group with their age of 53.08±4.94 years, and 5 patients including 1 female patient in the extremely-high-risk group with their age of 41.60±11.08 years. All the patients received Sun's procedure under deep hypothermic circulatory arrest and antegrade selective cerebral perfusion. EuroSCORE Ⅱ was used to predict postoperative mortality and prolonged ICU stay. ResultsIn-hospital mortality was 8.07% (31/384). Mean length of ICU stay was 3.06 days. Length of ICU stay of 42 patients was longer than 7 days. For low-risk group, the predicted mortality was lower than the actual mortality. For medium-risk, high-risk and extremely-high-risk groups, the predicted mortality was higher than the actual mortality. EuroSCORE Ⅱ showed unsatisfactory discriminatory ability to predict postoperative mortality and prolonged ICU stay. The area under ROC curve were 0.49 and 0.52 respectively. The calibration was also poor for predicting postoperative mortality and prolonged ICU stay (P<0.001). ConclusionsEuroSCORE Ⅱ is not satisfactory for predicting mortality and prolonged ICU stay after Sun's procedure for the treatment of STAAD. A new risk evaluating system specific for STAAD is needed.

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