INICIO

Continuation of the Revista Mexicana de Cardiología





2023, Number 4

Cardiovasc Metab Sci 2023; 34 (4)

The usefulness of the EuroSCORE II model for predicting surgery mortality in a high specialty hospital in Mexico

Teniente-Valente, Raúl; Martínez-Bautista, Humberto; Chagolla-Santillán, Miguel Ángel; Acevedo-Bañuelos,Iliana; Romo-Escamilla, Ricardo; García-Muñoz, Iván; Gutierrez-García, Mercedes Guadalupe; Rodríguez-Jiménez, José Carlos; Valente-Acosta, Benjamín; Vázquez-Martínez, Víctor Hugo

ABSTRACT

Introduction: the EuroSCORE model has been used in various countries, including México, to estimate the probability of surgery-associated mortality. Several studies have shown deficiencies in its calibration while retaining good discrimination. The model was updated in 2012 and called EuroSCORE II. Objective: to evaluate the calibration and discrimination of the EuroSCORE II model in patients undergoing cardiac surgery in a high specialty hospital in México. Material and methods: an observational, cross-sectional, and retrospective study was performed. Patients ≥ 16 years old years who underwent cardiac surgery between the years 2008-2013 were included. The hospital mortality rate was obtained, and the EuroSCORE II was calculated online. Discrimination of the EuroSCORE II model was evaluated with the area under the curve of a receiver operating characteristics curve (AUC-ROC), and the calibration was assessed using χ2 of Hosmer-Lemeshow (H-L) goodness of fit test and risk-adjusted ratio (RAMR). Results: three hundred thirty-eight patients were included. The mean age of participants was 49.8 ± 16.61 years; 162 were women (47.9%), and 176 (52.1%) were men. Surgery types were valvular 108 (31.9%), coronary revascularization 101 (29.8%), congenital 51 (15.08%), and other 78 (23.07%). The average EuroSCORE II was 4.1 (95% CI, 3.53-4.68). Mortality observed was 10.9%. The AUC-ROC was 0.806 (95% CI, 0.739-0.872), consistent with good discrimination. The χ2 of H-L of 14.2, p = 0.08, compatible with adequate calibration. The RAMR was 2.65, indicating an underestimation of the model. Conclusion: the EuroSCORE II model showed good discrimination. The calibration was adequate according to the χ2 of H-L, but the value of the RAMR suggests that the model underestimates the risk of mortality.