• Cheng-Hon Yap, Morteza Mohajeri, Benno U Ihle, Anthony C Wilson, Shiromani Goyal, and Michael Yii.
• Department of Cardiothoracic Surgery, St Vincent's Hospital in affiliation with Department of Surgery, University of Melbourne, Victoria, Australia. chenghon@internode.on.net
• ANZ J Surg. 2005 Jul 1; 75 (7): 508-12.

BackgroundThe purpose of the present paper was to assess the performance of the European system for cardiac operative risk evaluation (EuroSCORE) model in an Australian adult cardiac surgical population.MethodsThe additive and logistic EuroSCORE models were retrospectively applied to predict operative mortality in 2106 consecutive patients undergoing cardiac surgery at St Vincent's Hospital, Melbourne between June 2001 and August 2003, and at Geelong Hospital between June 2001 and April 2004. The entire cohort and a subset of patients undergoing isolated coronary artery bypass graft (CABG) surgery were analysed. Model discrimination and calibration was tested by determining the area under the receiver operating characteristic (ROC) curve and Hosmer-Lemeshow chi2, respectively.ResultsThere were significant differences in the prevalence of risk factors between the Australian and European cardiac surgical populations. There were 81 deaths (observed mortality 3.85%) in the entire cohort and 39 deaths in the isolated CABG group (observed mortality 2.60%). The EuroSCORE models overestimated mortality (entire cohort: additive predicted 5.75%, logistic predicted 9.93%; isolated CABG: additive predicted 4.87%, logistic predicted 7.71%). Discriminative power was very good for the entire cohort (area under ROC curve, 0.81 (additive) and 0.82 (logistic)). Calibration of both models was poor.ConclusionThe additive and logistic EuroSCORE model of risk prediction was not validated in the present population of cardiac surgical patients. The models may not accurately predict outcomes of patients undergoing cardiac surgery in Australia.

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