European System for Cardiac Operative Risk Evaluation
calculator
Method of calculating predicted operative mortality for patients undergoing cardiac surgery
Developed from 20,000 patients; 128 hospitals; 8 European countries (information collected from 97 risk factors in all patients)
Scoring System
PATIENT-RELATED FACTORS
Score
Age
per 5 years or part thereof over 60 years
1
Sex
Female
1
Chronic pulmonary disease
Longterm use of bronchodilators or steroids for lung disease
1
Extracardiac arteriopathy
Any one of the following:
carotid occlusion or >50% stenosis
previous / planned intervention on the abdominal aorta, limb arteries or carotids
2
Neurological dysfunction disease
Severely affecting ambulation or day to day functioning
2
Previous cardiac surgery
requiring opening of the pericardium
3
Serum creatinine
>200umol/l preoperatively
2
Active endocarditis
Patient still under antibiotic treatment for endocarditis at the time of surgery
3
Critical preoperative state
Any one or more of the following:
VT or VF
Aborted sudden death
Peroperative cardiac massage
Preoperative ventilation before arrival in the anaesthetic room
Preoperative inotropic support, IABP
Preoperative acute renal failure (anuria or oligouria <10ml/h)
3
CARDIAC-RELATED FACTORS
Unstable angina
Rest angina requiring iv nitrates until arrival in the anaesthetic room
2
LV dysfunction
Moderate / LVEF 30-50%
Poor / LVEF <30%
1
3
Recent myocardial infarct
<90 days
2
Pulmonary hypertension
Systolic PA pressure >60mmHg
2
OPERATION-RELATED FACTORS
Emergency
Carried out on referral before the beginning of the next working day
2
Other than isolated CABG
Major cardiac procedure other than or in addition to CABG
2
Surgery on the thoracic aorta
For disorder of ascending, arch or descending aorta
3
Postinfarct septal rupture
4
Logistic EuroSCORE
Additive EuroSCORE is established and validated - it is easy to use by the bedside and very valuable in quality control in cardiac surgery giving a useful estimate of risk in individual patients
In very high risk patients, the additive EuroSCORE may underestimate the risk when certain combinations of risk factors co-exist
Logistic EuroSCORE produces a more accurate risk prediction
