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Evaluation of results in coronary surgery using EuroSCORE

Mihajlović Bogoljub (Klinika za kardiovaskularnu hirurgiju, Institut za kardiovaskularne bolesti Vojvodine, Sremska Kamenica)
Nićin Svetozar (Klinika za kardiovaskularnu hirurgiju, Institut za kardiovaskularne bolesti Vojvodine, Sremska Kamenica)
Kovačević Pavle (Klinika za kardiovaskularnu hirurgiju, Institut za kardiovaskularne bolesti Vojvodine, Sremska Kamenica)
Šušak Stamenko (Klinika za kardiovaskularnu hirurgiju, Institut za kardiovaskularne bolesti Vojvodine, Sremska Kamenica)
Velicki Lazar (Klinika za kardiovaskularnu hirurgiju, Institut za kardiovaskularne bolesti Vojvodine, Sremska Kamenica)
Kovačević Dragan (Klinika za kardiologiju, Institut za kardiovaskularne bolesti Vojvodine, Sremska Kamenica)
Fabri Mikloš (Klinika za kardiovaskularnu hirurgiju, Institut za kardiovaskularne bolesti Vojvodine, Sremska Kamenica)

Introduction. The European System for Cardiac Operative Risk Evaluation (EuroSCORE) was developed in order to predict operative risk in cardiac surgery and to assess the quality of the cardio-surgical care. Introduction of the uniform terminology in result evaluation process leads to the significant improvement in measuring and evaluation of surgical treatment quality. Objective. The aim of the study was to evaluate our results in isolated coronary surgery using the EuroSCORE. Methods. The study was done respectively by analyzing predicted mortality according to the EuroSCORE model and observed operative risk in 4,675 coronary patients operated at our Clinic during the period 2001-2008. For statistical analyses, the Pearson, Chisquare and ANOVA tests were used. Results. The total postoperative mortality predicted by the EuroSCORE was 2.9±2.25, while the observed one was 2.2%. When the scoring system and observed results were compared over the years, a considerably lower observed mortality was found during the last 4 years. Overall average number of distal anastomoses was 2.62±0.84. During the period 2004-2008, the average number of coronary anastomoses increased over the years reaching the value of 2.77±0.88. The difference is at the level of statistical significance with the trend of further increase. Percentage of the patients with single or double graft myocardial revascularization decreases, while the number of the patients with triple or more bypasses increases. Conclusion. During the last years, the results in isolated coronary surgery have considerably improved. The EuroSCORE overestimates operative risk. In order to improve its predictive value, the model should be recalibrated.

Keywords: myocardial revascularization, risk stratification, coronary disease, surgery