Comparison of logistic EuroSCORE, SYNTAX and EuroSCORE II for predicting 1-year mortality in patients underwent coronary bypass surgery

Year 2018, Volume: 43 Number: Supplement 1, 222 - 229, 29.12.2018

Mehmet Atay , Burak Açıkgöz , Onur Saydam Ali Aycan Kavala Saygın Türkyılmaz Vedat Bakuy Mete Gürsoy Cabir Gülmalıyev İsmail Ungan Ahmet Akgül

https://doi.org/10.17826/cumj.422290

Abstract

Objectives: EuroSCORE II, logistic EuroSCORE and SYNTAX scores were compared in patients who underwent CABG in order to find the ideal scoring system for mortality.

Methods: This retrospective study attempted to examine the preoperative demographic characteristics, echocardiographic findings, operation notes and files, perfusion cards and observation notes of 228 patients who had undergone CABG surgery in our clinic.

Results: It was found that predictive point of SYNTAX score was greater than 27.5 (>27.5), the logistic regression (LR +) value was 1.5 in order to determine mortality rate.  Predictive value of EuroSCORE II was higher than 1.82 (>1.82) and LR+ value was 2.20. It was found that EuroSCORE II was enough to predict one-year mortality rate although its positive predictive value was low. Predictive value of logistic EuroSCORE was higher than 5.71 (>5.71) and the LR+ value was 5.13 to assess the mortality rate. Logistic EuroSCORE was also sufficient to predict one-year mortality rate.

Conclusion: Logistic EuroSCORE was found to be the most effective scoring system in predicting one-year mortality in this study. We conclude that randomized clinical trials need to be performed in order to find an ideal cardiac risk scoring system.

Keywords

CABG, risk analysis/modelling, mortality

Koroner bypass cerrahisi geçiren hastalarda 1-yıllık mortaliteyi öngörmede lojistik EuroSCORE, SYNTAX ve EuroSCORE II’nin karşılaştırılması

Abstract

Amaç: Bu çalışmanın amacı koroner arter bypass greftleme (CABG) operasyonu geçiren hastalarda mortalite açısından uygun skorlama sistemini bulmak amacı ile EuroSCORE II, Lojistik EuroSCORE ve SYNTAX skorlarının karşılaştırılmasıdır.

Gereç ve Yöntem: Kliniğimizde CABG cerrahisi geçiren 228 hastanın demografik özellikleri, ekokardiyografik bulguları, operasyon notları ve dosyaları, perfüzyon ve gözlem notları değerlendirildi. 

Bulgular: Mortaliteyi belirlemek amacıyla SYNTAX skorunun prediktif değeri 27.5’ten (>27.5) büyüktü, lojistik regresyon (LR+) değeri ise 1.5 idi. EuroSCORE II’nin prediktif değeri 1.82’den yüksekti (>1.82) ve LR+ değeri 2.20 idi. EuroSCORE II’nin pozitif prediktif değerinin düşük olmasına rağmen bir yıllık mortalite oranını tahmin etmede yeterli olduğu bulundu. Mortalite oranını değerlendirmede Lojistik EuroSCORE’un prediktif değeri 5.71’den büyüktü (>5.71) ve LR+ değeri 5.13 idi. Lojistik EuroSCORE da bir yillik mortalite oranini tahmin etmede yeterliydi.

Sonuç: Çalışmamızda bir yıllık mortaliteyi tahmin etmede Lojistik EuroSCORE en etkin skorlama sistemi olarak bulunmuştur. İdeal kardiyak risk skorlama sistemini bulmak için randomize klinik çalışmalara ihtiyaç olduğu kanısındayız.

Keywords

CABG, risk analizi/modelleme, mortalite

References

• Kültürsay H. Methods of risk estimation for cardiovascular disease. Arch Turk Soc Cardiol 2011;39 Suppl 4:6-13.
• Baykan OA, Çinçin A, Kefeli U, Caymaz U. Koroner Arter Revaskülarizasyonu Uygulanan Hastalarda SYNTAX Skorlama Sisteminin Erken Dönem Sonlanım Noktalarını Belirlemedeki Rolü. Türk Girişimsel Kard Der 2014;18:30-40.
• Cockroft D, Gault MK, Prediction of creatinine clearence from serum creatinine. Nephron 1976;16:31-41.
• Farrokhyar F, Wang X, Kent R, Lamy A. Early mortality from off-pump and on-pump coronary bypass surgery in Canada: A comparison of the STS and the EUROSCORE risk prediction algorithms. Can J Cardiol 2007;23(11):879-83.
• Ünüvar N, Mollahaliloğlu S, Yardım N. Türkiye hastalık yükü çalışması 2004. Ankara. Aydoğdu Ofset Matbaacılık; 2007.
• Mozaffarian D, Kamineni A, Carnethon M, Djoussé L, Mukamal KJ, Siscovick D. Lifestyle risk factors and new-onset diabetes mellitus in older adults: the cardiovascular health study. Arch Intern Med. 2009;169:798–8077.
• Van Klaveren D, Vergouwe Y, Farooq V, Serruys PW, Steyerberg EW. Estimates of absolute treatment benefit for individual patients required careful modeling of statistical interactions. J Clin Epidemol. 2015;68:1366-748.
• Iqbal J, Zhang YJ, Holmes DR, et al. Optimal medical therapy improves clinical outcomes in patients undergoing revascularization with percutaneous coronary intervention or coronary artery bypass grafting: insights from the Synergy Between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery (SYNTAX) trial at the 5-year follow-up. Circulation. 2015;131:1269-77.
• Karabulut A, Cakmak M. Treatment strategies in the left main coronary artery disease associated with acute coronary syndromes. J Saudi Heart Assoc. 2015;27:272-6
• Piek JJ, Claessen BE, Davies JE, Escaned J. Physiology-guided myocardial revascularisation in complex multivessel coronary artery disease: beyond the 2014 ESC/EACTS guidelines on myocardial revascularisation. Open Heart. 2015;2:e000308
• Akgül A, Gürsoy M, Bakuy V, et al. Koroner arter baypas greftleme sonrası erken mortalitenin belirlenmesinde standart, lojistik Euroscore ve EuroscoreII’nin karşılaştırılması. Anatol J Cardiol. 2013;13:425-31
• Kocabeyoğlu SS, Çetin E, Özyüksel A, et al. Yeni Bir Kalp Cerrahisi Kliniği: Diyarbakır Eğitim ve Araştırma Hastanesi’nde İlk 195 Vakanın Sonuçları. Kosuyolu Heart J 2014;17:20-5
• Yan LQ, Guo LJ, Zhang FC, Gao W. The Relationship between Kidney Function and Angiographically-Derived SYNTAX Score. Can J Cardiol. 2011;27:768–72
• Tuomilehto J, Borch-Johnsen K, Molarius A, et al. Incidence of cardiovascular disease in type 1 (insulin dependent) diabetic subjects with and without diabetic nephropathy in Finland. Diabetologia. 1998;41:784-90
• Yusuf S, Hawken S, Ounpuu S, et al. INTERHEART Study Investigators.Effects of potentially modifiable risk factors associated with myocardial infarction in 52 countries(the INTERHEART study): case control study. Lancet. 2004;364:937-52
• Kaya M, İyigün T, İyigün M, Bakır İ, Yeniterzi M. The results of coronary artery surgery in women and men under the age of 45. Türk Gogus Kalp Dama 2013;21:581-7
• Zhang YJ, Iqbal J, Van Klaveren D, et al. Smoking is associated with adverse clinical outcomes in patients undergoing revascularization with PCI or CABG: the SYNTAX trial at 5-year follow-up. J Am Coll Cardiol. 2015;65:1107-15
• Hamulu A, Özbaran M, Atay Y, et al. Koroner bypass ameliyatında mortalite ve morbiditeye etki eden risk faktörlerinin belirlenmesi ve değerlendirilmesi. GKD Cer Derg 1995;3:245-52
• Kutay V, Ekim H, Kırali K, Güler M, Yakut C. Van ve Çevre İllerde Yaşayan Koroner Arter Hastalarının Profili ve CABG Sonuçları. Türk Göğüs Kalp Damar Cerr Derg 2003;11:1-4
• Fukui T, Uchimuro T, Takanashi S. EuroSCORE II with SYNTAX score to assess risks of coronary artery bypass grafting outcomes. Eur J Cardiothorac Surg. 2015;47:66-71
• Capodanno D, Miano M, Cincotta G, et al. Euroscore refines the predictive ability of SYNTAX score in patiens undergoing left main percutaneous coronary intervention. Am Heart J. 2010;159:103-9
• Kunt AG, Kurtcephe M, Hidiroglu M, et al. Comparison of original EuroSCORE, EUROSCORE II and STS risk models in a Turkish cardiac surgical cohort. Interact Cardiovasc Thorac Surg. 2013;16:625-9