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Interact Cardiovasc Thorac Surg · May 2010
Comparative StudyThe role of EuroSCORE in patients undergoing off-pump coronary artery bypass.
- Hitoshi Hirose, Chiaki Noguchi, Hirotaka Inaba, Keiichi Tambara, Taira Yamamoto, Motoshige Yamasaki, Keita Kikuchi, and Atsushi Amano.
- Department of Cardiovascular Surgery, Juntendo University Hospital, Bunko-ku, Tokyo, 113-8421, Japan.
- Interact Cardiovasc Thorac Surg. 2010 May 1; 10 (5): 771-6.
IntroductionEuropean System for Cardiac Operative Risk Evaluation (EuroSCORE) has been used to predict the postoperative mortality rate for patients undergoing open-heart surgery. The contributions of EuroSCORE in off-pump coronary artery bypass grafting (CABG) has not yet clearly elucidated.MethodsConsecutive patients of isolated off-pump CABG performed from 2000 when we start performing 'routine' off-pump procedures were stratified using the additive EuroSCORE. Incidence of postoperative mortality, morbidity, and recovery were assessed, and compared to an historical cohort of on-pump procedures performed between 1991 until 1998 when CABG had been routinely performed under on-pump.ResultsThere were 1318 patients in the off-pump and 1162 patients in the on-pump group. EuroSCORE of the off-pump group was significantly higher than that of the on-pump group. In both the on- and off-pump groups, mortality, total incidence of major complications, heart failure, and renal failure, and three parameters of recovery time were well correlated with EuroSCORE; however, the discriminatory power of the EuroSCORE model was always better in the on-pump group than in the off-pump group. Stroke was correlated with EuroSCORE only in the on-pump group. Pneumonia, mediastinitis postoperative myocardial infarction, or mediastinitis was not correlated with EuroSCORE in either group. In the off-pump group, postoperative major complication was reduced and postoperative recovery was shortened significantly, compared to those in the on-pump group.ConclusionIn off-pump CABG, EuroSCORE can, but not as good as in on-pump CABG, predict mortality, certain major postoperative complications, and postoperative recovery. This suggests off-pump technique appears to modify the risk stratification of the patients undergoing CABG.2010 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.
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