The role of EuroSCORE in patients undergoing off-pump coronary artery bypass.

Authors

Hitoshi Hirose, Department of Surgery, Thomas Jefferson University; Department of Cardiovascular Surgery, Juntendo University HospitalFollow
Chiaki Noguchi, Department of Surgery, Tokyo UniversityFollow
Hirotaka Inaba, Department of Cardiovascular Surgery, Juntendo University HospitalFollow
Keiichi Tambara, Department of Cardiovascular Surgery, Juntendo University HospitalFollow
Taira Yamamoto, Department of Cardiovascular Surgery, Juntendo University HospitalFollow
Motoshige Yamasaki, Department of Cardiovascular Surgery, Juntendo University HospitalFollow
Keita Kikuchi, Department of Cardiovascular Surgery, Juntendo University HospitalFollow
Atsushi Amano, Department of Cardiovascular Surgery, Juntendo University HospitalFollow

Document Type

Article

Publication Date

5-1-2010

Comments

This is a link to an open access article. This article has been peer reviewed and is published in Interactive Cardiovascular and Thoracic Surgery 2010 May;10(5):771-6. DOI: 10.1510/icvts.2009.226803. ©Oxford University Press

Abstract

INTRODUCTION: European 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.

METHODS: Consecutive 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.

RESULTS: There 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.

CONCLUSION: In 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.

Recommended Citation

Hirose, Hitoshi; Noguchi, Chiaki; Inaba, Hirotaka; Tambara, Keiichi; Yamamoto, Taira; Yamasaki, Motoshige; Kikuchi, Keita; and Amano, Atsushi, "The role of EuroSCORE in patients undergoing off-pump coronary artery bypass." (2010). Department of Surgery Faculty Papers. Paper 52.
https://jdc.jefferson.edu/surgeryfp/52

PubMed ID

20103507