Validation of European System for Cardiac Operative Risk Evaluation in Heart Valve Surgery of Uyghur Patients and Han Nationality Patients_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YUJin , XUWei-fang , LIFan , LIANGYuan-yuan , WANGJiang ,  ZHENGHong

Department of Anesthesiology, The First Teaching Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China;

Corresponding author：

ZHENGHong, Email: xjzhenghong@aliyun.com

Keywords：

European system for cardiac operative risk evaluation; Cardiac valve surgery; Uyghur; Risk score; Mortality

DOI：

10.7507/1007-4848.20150138

Video：

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Objective To assess the accuracy of European System for Cardiac Operative Risk Evaluation (EuroSCORE) model in predicting the in-hospital mortality of Uyghur patients and Han nationality patients undergoing heart valve surgery. Methods Clinical data of 361 consecutive patients who underwent heart valve surgery at our center from September 2012 to December 2013 were collected, including 209 Uyghur patients and 152 Han nationality patients. According to the score for additive and logistic EuroSCORE models, the patients were divided into 3 subgroups including a low risk subgroup, a moderate risk subgroup, and a high risk subgroup. The actual and predicted mortality of each risk subgroup were studied and compared. Calibration of the EuroSCORE model was assessed by the test of goodness of fit, discrimination was tested by calculating the area under the receiver operating characteristic (ROC) curve. Results The actual mortality was 8.03% for overall patients, 6.70% for Uyghur patients,and 9.87% for Han nationality patients. The predicted mortality by additive EuroSCORE and logistic EuroSCORE for Uyghur patients were 4.03% and 3.37%,for Han nationality patients were 4.43% and 3.77%, significantly lower than actual mortality (P<0.01). The area under the ROC curve of additive EuroSCORE and logistic EuroSCORE for overall patients were 0.606 and 0.598, for Han nationality patients were 0.574 and 0.553,and for Uyghur patients were 0.609 and 0.610. Conclusion The additive and logistic EuroSCORE are unable to predict the in-hospital mortality accurately for Uyghur and Han nationality patients undergoing heart valve surgery. Clinical use of these model should be considered cautiously.

Citation： YUJin, XUWei-fang, LIFan, LIANGYuan-yuan, WANGJiang, ZHENGHong. Validation of European System for Cardiac Operative Risk Evaluation in Heart Valve Surgery of Uyghur Patients and Han Nationality Patients. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(6): 540-548. doi: 10.7507/1007-4848.20150138 Copy

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3.	Roques F, Nashef SA, Michel P, et al. Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients. Eur J Cardiothorac Surg, 1999, 15(6): 816-822.
4.	汪炜健, 张浩, 李立环. 欧洲心血管手术危险因素评分系统简介. 临床麻醉学杂志, 2006, 22(7): 559-560.
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9.	Roques F, Nashef SA, Michel P, et al. Regional differences in surgical heart valve disease in Europe: comparison between northern and southern subsets of the EuroSCORE database. J Heart Valve Dis, 2003, 12(1): 1-6.
10.	雷迁, 于钦军, 陈雷. 心脏手术围术期危险因素的术前评估. 临床麻醉学杂志, 2007, 23(11):953-955.
11.	Granton J, Cheng D. Risk stratification models for cardiac surgery. Semin Cardiothorac Vasc Anesth. 2008, 12(3): 167-74.
12.	Litmathe J, Kurt M, Feindt P, et al. Predictors and outcome of ICU readmission after cardiac surgery. Thorac Cardiovasc Surg, 2009, 57(7): 391-394.
13.	Borracci RA, Rubio M, Baldi HJ, et al. Cardiac surgery stratified by EuroSCORE. Long-term survival. Medicina (B Aires), 2013, 73(5): 438-442.
14.	Bouma W, Wijdh-den Hamer IJ, Koene BM, et al. Predictors of in-hospital mortality after mitral valve surgery for post-myocardial infarction papillary muscle rupture. J Cardiothorac Surg, 2014, 9(1): 171.
15.	Andrade IN, Moraes Neto FR, Andrade TG, et al. Use of Euro-SCORE as a predictor of morbidity after cardiac surgery. Rev Bras Cir Cardiovasc, 2014, 29(1): 9-15.
16.	Grant SW, Hickey GL, Dimarakis I, et al. Performance of the EuroSCORE models in emergency cardiac surgery. Circ Cardiovasc Qual Outcomes, 2013, 6(2): 178-185.
17.	邓木兰, 李河, 陈剑光, 等. 广东、新疆中小学生及成人风湿性心瓣膜病流行病学调查. 南方医科大学学报, 2009, 29(9): 1902-1904.
18.	王崇, 韩林, 张冠鑫, 等. 心脏瓣膜手术在院死亡风险预测模型及评分标准的建立. 中国胸心血管外科临床杂志, 2011, 18(1): 2-10.
19.	Zheng Z, Li Y, Zhang SJ, et al. The Chinese Coronary Artery Bypass Grafting Registry Study: how well does the EuroSCORE predict operative risk for Chinese population? Eur J Cardiothorac Surg, 2009, 35(1): 54-58.
20.	Parolari A, Pesce LL, Trezzi M, et al. EuroSCORE performance in valve surgery: a meta-analysis. Ann Thorac Surg, 2010, 89(3): 787-793.
21.	王崇, 张冠鑫, 韩林, 等. EuroSCORE模型对心瓣膜手术患者死亡风险的预测. 中国胸心血管外科临床杂志, 2011, 18(3): 189-193.

1. 艾斯卡尔, 阿布都乃比, 木拉提, 等. 新疆地区913例心脏瓣膜置换术的临床分析. 中华医学杂志, 2010, 90(44): 3153-3155.
2. 江学成. 麻醉和手术风险数字化评估方法解读. 临床麻醉学杂志, 2007, 23(11): 947-949.
3. Roques F, Nashef SA, Michel P, et al. Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients. Eur J Cardiothorac Surg, 1999, 15(6): 816-822.
4. 汪炜健, 张浩, 李立环. 欧洲心血管手术危险因素评分系统简介. 临床麻醉学杂志, 2006, 22(7): 559-560.
5. Roques F, Michel P, Goldst one AR, et al. The logistic EuroSCORE. Eur J Cardiothorac Surg, 2003, 24(6): 881-882.
6. Keogh B, Kinsman R. Fifth national adult cardiac surgical dat abase report. society of cardiothoracic surgeons of great britain and Ireland, 2003 [2005-06-21]. http://www.scts.org.
7. Krane M, Voss B, Hiebinger A, et al. Twenty years of cardiac surgery in patients aged 80 years and older: risks and benefits. Ann Thorac Surg, 2011, 91(2): 506-513.
8. Rabkin E, Schoen FJ. Cardiovascular tissue engineering. Cardiovasc Pathol, 2002, 11(6): 305-317.
9. Roques F, Nashef SA, Michel P, et al. Regional differences in surgical heart valve disease in Europe: comparison between northern and southern subsets of the EuroSCORE database. J Heart Valve Dis, 2003, 12(1): 1-6.
10. 雷迁, 于钦军, 陈雷. 心脏手术围术期危险因素的术前评估. 临床麻醉学杂志, 2007, 23(11):953-955.
11. Granton J, Cheng D. Risk stratification models for cardiac surgery. Semin Cardiothorac Vasc Anesth. 2008, 12(3): 167-74.
12. Litmathe J, Kurt M, Feindt P, et al. Predictors and outcome of ICU readmission after cardiac surgery. Thorac Cardiovasc Surg, 2009, 57(7): 391-394.
13. Borracci RA, Rubio M, Baldi HJ, et al. Cardiac surgery stratified by EuroSCORE. Long-term survival. Medicina (B Aires), 2013, 73(5): 438-442.
14. Bouma W, Wijdh-den Hamer IJ, Koene BM, et al. Predictors of in-hospital mortality after mitral valve surgery for post-myocardial infarction papillary muscle rupture. J Cardiothorac Surg, 2014, 9(1): 171.
15. Andrade IN, Moraes Neto FR, Andrade TG, et al. Use of Euro-SCORE as a predictor of morbidity after cardiac surgery. Rev Bras Cir Cardiovasc, 2014, 29(1): 9-15.
16. Grant SW, Hickey GL, Dimarakis I, et al. Performance of the EuroSCORE models in emergency cardiac surgery. Circ Cardiovasc Qual Outcomes, 2013, 6(2): 178-185.
17. 邓木兰, 李河, 陈剑光, 等. 广东、新疆中小学生及成人风湿性心瓣膜病流行病学调查. 南方医科大学学报, 2009, 29(9): 1902-1904.
18. 王崇, 韩林, 张冠鑫, 等. 心脏瓣膜手术在院死亡风险预测模型及评分标准的建立. 中国胸心血管外科临床杂志, 2011, 18(1): 2-10.
19. Zheng Z, Li Y, Zhang SJ, et al. The Chinese Coronary Artery Bypass Grafting Registry Study: how well does the EuroSCORE predict operative risk for Chinese population? Eur J Cardiothorac Surg, 2009, 35(1): 54-58.
20. Parolari A, Pesce LL, Trezzi M, et al. EuroSCORE performance in valve surgery: a meta-analysis. Ann Thorac Surg, 2010, 89(3): 787-793.
21. 王崇, 张冠鑫, 韩林, 等. EuroSCORE模型对心瓣膜手术患者死亡风险的预测. 中国胸心血管外科临床杂志, 2011, 18(3): 189-193.

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Validation of European System for Cardiac Operative Risk Evaluation in Heart Valve Surgery of Uyghur Patients and Han Nationality Patients

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