Document Detail

Is EuroSCORE applicable to Indian patients undergoing cardiac surgery?
MedLine Citation:
PMID:  20826966     Owner:  NLM     Status:  MEDLINE    
Indian patients undergoing cardiac surgery have different demographics, clinical profile as well as risk profile, compared to the western population. The purpose of this study was to validate the European System for Cardiac Operative Risk Evaluation (EuroSCORE) risk stratification model in Indian patients undergoing cardiac surgery in a single cardiac center. Data from 1000 consecutive adult patients undergoing cardiac surgery (coronary artery bypass grafting or valve surgery) were prospectively collected as per the EuroSCORE model. The model's validity was assessed on the basis of its calibration power (Hosmer-Lemeshow test) and discriminatory power [area under receiver operating characteristic curve]. The patients were divided into three risk groups on the basis of their EuroSCORE. The Hosmer-Lemeshow test revealed a good calibration power (P = 0.73) and the area under the ROC curve was 0.8278, suggesting a good discriminative power. The predicted mortality was similar to observed mortality in low- and moderate-risk patients but the observed mortality in high-risk patients (15.6%) was double that of predicted mortality (7.5%). The risk factors prevalent in European population were not observed in Indian population. EuroSCORE accurately predicts mortality in low and moderate-risk Indian patients undergoing cardiac surgery but is less predictive for high-risk Indian patients. Updating and improvisation of EuroSCORE by incorporation of risk factors associated with rheumatic valvular heart disease which is more prevalent in India, may enable it to accurately predict mortality in high-risk patients also.
Madhur Malik; Sandeep Chauhan; Vishwas Malik; Parag Gharde; Usha Kiran; R M Pandey
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of cardiac anaesthesia     Volume:  13     ISSN:  0974-5181     ISO Abbreviation:  Ann Card Anaesth     Publication Date:    2010 Sep-Dec
Date Detail:
Created Date:  2010-09-09     Completed Date:  2010-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815987     Medline TA:  Ann Card Anaesth     Country:  India    
Other Details:
Languages:  eng     Pagination:  241-5     Citation Subset:  IM    
Department of Cardiac Anaesthesia, All India Institute of Medical Sciences, New Delhi, India.
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MeSH Terms
Cardiac Surgical Procedures / mortality,  standards*
Coronary Artery Bypass
Middle Aged
ROC Curve
Reproducibility of Results
Risk Assessment / methods*
Treatment Outcome
Young Adult

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