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Ann Thorac Surg 2005;79:1902-1908
© 2005 The Society of Thoracic Surgeons

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Original article: Cardiovascular

EuroSCORE Predicts Long-Term Mortality After Heart Valve Surgery

^a Department of Cardiothoracic Surgery, Columbia University College of Physicians and Surgeons, St. Luke’s-Roosevelt Hospital Center, New York, New York
^b Department of Cardiac Surgery, University of Athens School of Medicine, Attikon Hospital Center, Athens, Greece

Accepted for publication December 20, 2004.

^_* Address reprint requests to Dr Toumpoulis, St. Luke’s-Roosevelt Hospital Center at Columbia University, 515 West 59th Street, New York, NY 10019 (E-mail: toumpoul{at}otenet.gr).

BACKGROUND: The European System for Cardiac Operative Risk Evaluation (EuroSCORE) is the most rigorously evaluated scoring system in cardiac surgery. We sought to evaluate the performance of EuroSCORE in the prediction of long-term mortality in patients undergoing heart valve surgery.

METHODS: Medical records of patients with isolated or combined heart valve surgery, who were discharged alive (n = 1035), were retrospectively reviewed. Their operative surgical risks were calculated according to EuroSCORE model (standard and logistic). Long-term survival data (mean follow-up 4.5 ± 3.1 years) were obtained from the National Death Index. Kaplan-Meier curves of the quartiles of standard and logistic EuroSCORE were plotted.

RESULTS: The estimated 5-year survival rates of the quartiles in the standard and logistic EuroSCORE model were: 90.0% ± 2.3%, 85.1% ± 2.3%, 64.8% ± 3.3%, and 55.1% ± 3.7% (p < 0.0001, log-rank test with adjustment for trend) and 90.4% ± 2.2%, 86.4% ± 2.5%, 66.9% ± 3.3%, and 56.1% ± 3.3% (p < 0.0001, log-rank test with adjustment for trend) respectively. The odds of death in the highest-risk quartile were 7.46- and 7.82-fold higher than the odds of death in the lowest-risk quartile for standard and logistic EuroSCORE respectively.

CONCLUSIONS: EuroSCORE can be used to predict not only in-hospital mortality, for which it was originally designed, but also long-term mortality in the whole context of heart valve surgery. This outcome can be predicted using the standard EuroSCORE, which is very simple and easy in its calculation.

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