[Application of preoperative risk severity evaluation system (EuroSCORE=European system for cardiac operative risk evaluation) for cardiac operative patients].

BACKGROUND: There is no widespread, well-accepted preoperative risk evaluation system for cardiac operative patients in Japan. We evaluated a scoring system for the prediction of postoperative morbidity and mortality in Japanese cardiac surgical patients.

METHODS: Between August 1, 2002 and July 31, 2003 154 patients undergoing heart surgery with cardiopulmonary bypass were scored according to EuroSCORE (European system for cardiac operative risk evaluation). All patients were divided into three risk groups, low risk group (score 0-2), medium risk group (score 3-5), and high risk group (score 6 plus). We studied correlations between score points and postoperative morbidity and mortality. Data were analyzed using chi2 test, with a P-value of less than 0.05 as significant.

RESULTS: The mean preoperative risk score was 5.6. The increase in preoperative risk score was associated with an increase in postoperative length of ventilation support and ICU stay. The low risk group had 35 patients with 0 death (0%), 5 morbidity (14.2%). The medium risk group had 57 patients with 2 death (3.5%), 14 morbidity (24.6%). The high risk group had 62 patients with 9 death (14.5%), 35 morbidity (56.5%). Overall, there were 11 death (7.1%), 54 morbidity (35.1%) in 154 patients. The risk score point correlated with postoperative morbidity and mortality.

CONCLUSIONS: In spite of the limitation of total patient's number (N = 154) in this study, we recommend EuroSCORE as a simple and essential tool for the risk assesment of cardiac surgery and prediction of postoperative morbidity and mortality.