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EuroSCORE risk prediction algorithm for cardiac surgical mortality

EuroSCORE risk prediction algorithm for cardiac surgical mortality
Predictor Definition Risk points*
Age Per 5 years or part thereof over 60 years 1
Sex Female 1
Chronic pulmonary disease Long-term use of bronchodilators or steroids for lung disease 1
Extracardiac arteriopathy Any one or more of the following: 2
claudication
carotid occlusion or >50% stenosis
previous or planned intervention on the abdominal aorta, limb arteries, or carotids
Neurological dysfunction Disease severely affecting ambulation or day-to-day functioning 2
Previous cardiac surgery Requiring opening of the pericardium 3
Serum creatinine >200 micromol/L (2.3 mg/dL) 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: 3
ventricular tachycardia or fibrillation or aborted sudden death
preoperative cardiac massage
preoperative ventilation before arrival in the anesthetic room
preoperative inotropic support
intraaortic balloon counterpulsation
preoperative acute renal failure (anuria or oliguria <10 mL/hour)
Unstable angina Rest angina requiring IV nitrates until arrival in the anesthetic room 2
LV dysfunction Moderate or LV ejection fraction 30 to 50% 1
Poor or LV ejection fraction <30% 3
Recent myocardial infarct <90 days 2
Pulmonary hypertension Systolic pulmonary artery pressure >60 mmHg 2
Emergency operation 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 thoracic aorta For disorder of ascending, arch or descending aorta 3
Postinfarct septal rupture   4
IV: intravenous; LV: left ventricle; CABG: coronary artery bypass grafting.
* To calculate the estimated perioperative mortality risk, the sum of the risk points is determined. Scores are stratified into low risk (0 to 2 points; estimated mortality 1.3 percent), medium risk (3 to 5 points; estimated mortality 2.9 percent) and high risk (≥6 points; estimated mortality 10.9 to 11.5 percent).
Reproduced with permission from: Nashef SA, Roques F, Michel P, et al. European system for cardiac operative risk evaluation (EuroSCORE). Eur J Cardiothorac Surg 1999; 16:9. Copyright © 1999 Elsevier.
Graphic 82521 Version 6.0

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