Predictive Surgical Outcome of EuroSCORE II for Active Endocarditis

Abstract

The European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) was developed from the original EuroSCORE (1999) to predict the mortality rate of patients undergoing cardiac surgery. Euro­SCORE II underestimates post–cardiac surgery mortality in high risk patients. There are few studies of the as­sociation between EuroSCORE II and mortality rate of patients with active endocarditis, and long term survival. The purpose of this study was to evaluate the accuracy of EuroSCORE II in predicting hospital mortality rate of active endocarditis patients underwent cardiac surgery. A retrospective study was performed at Maharat Nakhon Ratchasima Hospital, a Northeastern referral hospital, Thailand. Active endocarditis patients, aged 18 years or more, underwent cardiac surgery in the active phase during 2008 to 2017 were recruited into the study. Hospital mortality rate of the patients were compared of EuroSCORE II. From 121 patients undergoing cardiac surgery, 24 were dead, the mortality rate of 19.8%. The five years survival rate was 94.6%. The EuroSCORE II was classified into 5 rating scales, group I (score 0-<10) death 7.1%, group II (score 10-<20) death 32.0%, group III (score 20-<30), death 29.4%, group IV (score 30-<40) death 66.7%, and group V (score>40) death 66.7%, and the cut–off point was 12 and over. EuroSCORE II scores of 12 and above had a sensitivity of 40.9%, a specificity of 92.2%, a positive predictive value and negative predictive value of 75% and 73.2%, respectively. There was no association between EuroSCORE II and actual mortality rate particularly in severe cases. Therefore Euro­SCORE II should be used with caution for making a decision for cardiac surgery especially in group with severe active endocarditis (EuroSCORE II >12).