TY - JOUR
T1 - Validation of EuroSCORE II in atrial fibrillation heart surgery patients from the KROK Registry
AU - Kuzma, Lukasz
AU - Kowalewski, Mariusz
AU - Wanha, Wojciech
AU - Dabrowski, Emil Julian
AU - Jasinski, Marek
AU - Widenka, Kazimierz
AU - Deja, Marek
AU - Bartus, Krzysztof
AU - Hirnle, Tomasz
AU - Wojakowski, Wojciech
AU - Lorusso, Roberto
AU - Tobota, Zdzislaw
AU - Maruszewski, Bohdan J
AU - Suwalski, Piotr
AU - KROK Investigators
PY - 2023/8/10
Y1 - 2023/8/10
N2 - The study aimed to validate the European System for Cardiac Operative Risk Evaluation score (EuroSCORE II) in patients with atrial fibrillation (AF). All data were retrieved from the National Registry of Cardiac Surgery Procedures (KROK). EuroSCORE II calibration and discrimination performance was evaluated. The final cohort consisted of 44,172 patients (median age 67, 30.8% female, 13.4% with AF). The in-hospital mortality rate was 4.14% (N?=?1830), and 5.21% (N?=?2303) for 30-day mortality. EuroSCORE II significantly underestimated mortality in mild- and moderate-risk populations [Observed (O):Expected (E)-1.1, 1.16). In the AF subgroup, it performed well [O:E-0.99), whereas in the very high-risk population overestimated mortality (O:E-0.9). EuroSCORE II showed better discrimination in AF (-) [area under curve (AUC) 0.805, 95% CI 0.793-0.817)] than in AF (+) population (AUC 0.791, 95%CI 0.767-0.816), P?<?0.001. The worst discriminative performance for the AF (+) group was for coronary artery bypass grafting (CABG) (AUC 0.746, 95% CI 0.676-0.817) as compared with AF (-) population (AUC 0.798, 95% CI 0.774-0.822), P?<?0.001. EuroSCORE II is more accurate for patients with AF. However, it underestimated mortality rates for low-to-moderate-risk patients and had a lower ability to distinguish between high- and low-risk patients with AF, particularly in those undergoing coronary artery bypass grafting.
AB - The study aimed to validate the European System for Cardiac Operative Risk Evaluation score (EuroSCORE II) in patients with atrial fibrillation (AF). All data were retrieved from the National Registry of Cardiac Surgery Procedures (KROK). EuroSCORE II calibration and discrimination performance was evaluated. The final cohort consisted of 44,172 patients (median age 67, 30.8% female, 13.4% with AF). The in-hospital mortality rate was 4.14% (N?=?1830), and 5.21% (N?=?2303) for 30-day mortality. EuroSCORE II significantly underestimated mortality in mild- and moderate-risk populations [Observed (O):Expected (E)-1.1, 1.16). In the AF subgroup, it performed well [O:E-0.99), whereas in the very high-risk population overestimated mortality (O:E-0.9). EuroSCORE II showed better discrimination in AF (-) [area under curve (AUC) 0.805, 95% CI 0.793-0.817)] than in AF (+) population (AUC 0.791, 95%CI 0.767-0.816), P?<?0.001. The worst discriminative performance for the AF (+) group was for coronary artery bypass grafting (CABG) (AUC 0.746, 95% CI 0.676-0.817) as compared with AF (-) population (AUC 0.798, 95% CI 0.774-0.822), P?<?0.001. EuroSCORE II is more accurate for patients with AF. However, it underestimated mortality rates for low-to-moderate-risk patients and had a lower ability to distinguish between high- and low-risk patients with AF, particularly in those undergoing coronary artery bypass grafting.
KW - Humans
KW - Female
KW - Male
KW - Atrial Fibrillation/surgery etiology
KW - Risk Assessment/methods
KW - Cardiac Surgical Procedures/adverse effects
KW - Coronary Artery Bypass/adverse effects
KW - Risk Factors
KW - Hospital Mortality
KW - Registries
KW - Retrospective Studies
U2 - 10.1038/s41598-023-39983-w
DO - 10.1038/s41598-023-39983-w
M3 - Article
SN - 2045-2322
VL - 13
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 13024
ER -