Assessment of three risk evaluation systems for patients aged ≥70 in East China: performance of SinoSCORE, EuroSCORE II and the STS risk evaluation system

PeerJ

article

Lingtong Shan¹  Wen Ge²  Yiwei Pu¹  Hong Cheng³  Zhengqiang Cang¹  Xing Zhang¹  Qifan Li¹  Anyang Xu⁴  Qi Wang¹  Chang Gu⁵  Yangyang Zhang⁶ 

[1] The First Clinical Medical College, Nanjing Medical University;Department of Cardiothoracic Surgery, Shuguang Hospital affiliated to Shanghai University of TCM;Department of Neurology, Jiangsu Province People’s Hospital, The First Affiliated Hospital of Nanjing Medical University;Department of Chronic and Noncommunicable Disease, Shanghai Changning District Center for Disease Control and Prevention;Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai JiaoTong University;Key Laboratory of Arrhythmias of the Ministry of Education of China, East Hospital, Tongji University School of Medicine;Department of Cardiovascular Surgery, East Hospital, Tongji University School of Medicine;Department of Thoracic and Cardiovascular Surgery, Jiangsu Province People’s Hospital, The First Affiliated Hospital of Nanjing Medical University

关键词: Coronary artery bypass grafting;    EuroSCORE II;    STS score;    SinoSCORE;    Risk evaluation system;    Elderly;   

DOI  :  10.7717/peerj.4413

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

ObjectivesTo assess and compare the predictive ability of three risk evaluation systems (SinoSCORE, EuroSCORE II and the STS risk evaluation system) in patients aged ≥70, and who underwent coronary artery bypass grafting (CABG) in East China.MethodsThree risk evaluation systems were applied to 1,946 consecutive patients who underwent isolated CABG from January 2004 to September 2016 in two hospitals. Patients were divided into two subsets according to their age: elderly group (age ≥70) with a younger group (age <70) used for comparison. The outcome of interest in this study was in-hospital mortality. The entire cohort and subsets of patients were analyzed. The calibration and discrimination in total and in subsets were assessed by the Hosmer–Lemeshow and the C statistics respectively.ResultsInstitutional overall mortality was 2.52%. The expected mortality rates of SinoSCORE, EuroSCORE II and the STS risk evaluation system were 0.78(0.64)%, 1.43(1.14)% and 0.78(0.77)%, respectively. SinoSCORE achieved the best discrimination (the area under the receiver operating characteristic curve (AUC) = 0.829), followed by the STS risk evaluation system (AUC = 0.790) and EuroSCORE II (AUC = 0.769) in the entire cohort. In the elderly group, the observed mortality rate was 4.82% while it was 1.38% in the younger group. SinoSCORE (AUC = .829) also achieved the best discrimination in the elderly group, followed by the STS risk evaluation system (AUC = .730) and EuroSCORE II (AUC = 0.640) while all three risk evaluation systems all had good performances in the younger group. SinoSCORE, EuroSCORE II and the STS risk evaluation system all achieved positive calibrations in the entire cohort and subsets.ConclusionThe performance of the three risk evaluation systems was not ideal in the entire cohort. In the elderly group, SinoSCORE appeared to achieve better predictive efficiency than EuroSCORE II and the STS risk evaluation system.

【 授权许可】

CC BY