Mahmut Murat DEMİRTAŞ, Mehmet KAPLAN, Serdar ÇİMEN, Mustafa Sinan KUT

EuroSCORE (European System for Cardiac Operative Risk Evaluation) risk skorlama sisteminin ülkemiz hasta profilinde uygulanabilirliğinin araştırılması

Amaç: Kalp cerrahisinde operasyon öncesi dönemde mortalite tahmininde kullanılan risk skorlaması sistemlerinden biri, European System for Cardiac Operative Risk Evaluation (EuroSCORE) skorlama sistemidir. Çalışmamızın amacı, EuroSCORE'un kliniğimiz şartlarında ülkemiz hasta profiline uygulanabilirliğini araştırmak ve uygunluğunu test etmektir. Materyal ve Metod: Opere ettiğimiz ardışık kardiyak cerrahi olgularında, risk skorlaması için EuroSCORE sistemini prospektif olarak kullandık. Yüzdördü kadın olan toplam 320 hastanın ortalama yaşı 54.9 ± 12.6 idi. Hastaların 225'i koroner arter bypass (Grup 1), 95'i ise kapak (Grup 2) operasyonu geçirdi. Tüm hastaların 179'u düşük risk (ortalama risk skoru 0.99 ± 0.84), 115'i orta risk (ortalama risk skoru 3.79 ± 0.79) ve 26'sı ise yüksek risk grubunda (ortalama risk skoru 6.58 ± 0.93) idi. Bulgular: Beklenen ve gerçekleşen mortalite genel olarak tüm hastalarda 2.53 ± 1.63 ve 3.75 (p = 0.376) iken; düşük, orta ve yüksek risk gruplarında sırasıyla %1.38 ± 0.24 ve %1.67 (p = 1), %2.83 ± 0.8 ve %4.35 (p = 0.722), %6.48 ± 1.55 ve 15.38 (p = 0.668) olarak gerçekleşti. Operasyon çeşitlerine göre risk skorlama analizinde ise, beklenen ve gerçekleşen mortalite sırasıyla Grup 1'de 2.51 ± 1.74 ve 3.11 (p =1 ), Grup 2'de ise 2.29 ± 1.64 ve 5.26 (p = 0.721) idi. 'Receiver Operating Characteristic' eğrisi altındaki alan ameliyat edilen tüm hastalar için 0.767, koroner grubu için 0.749 ve kapak grubu için ise 0.808 olarak saptandı. Sonuç: Beklenen ve gerçekleşen mortalite oranlarına bakıldığında, EuroSCORE risk skorlama sisteminin ülkemiz hasta profilinde, özellikle koroner arter bypass ve kapak operasyonu uygulanan hastalar için uygun ve kolay uygulanabilen bir sistem olduğu görülmektedir.

Applicability of Euroscore (European System for Cardiac Operative Risk Evaluation) risk scoring system in Turkish patients

Background: European System for Cardiac Operative Risk Evaluation (EuroSCORE) is one of the scoring systems used to predict postoperative mortality before cardiac operations. We aimed to investigate applicability and adequacy of EuroSCORE in Turkish patient population. Methods: We prospectively used EuroSCORE system for risk scoring in our consecutive cardiac surgery patients. A total of 320 patients (216 male, 104 female) with a mean age of 54.9 ± 12.6 years were included. Coronary artery bypass grafting operation was done in 225 patients (Group 1), and 95 patients had valvular operations (Group 2). Patients were allocated to risk groups as follows: 179 low-risk patients (mean risk score: 0.99 ± 0.84), 115 intermediate-risk patients (mean risk score: 3.79 ± 0.79) and 26 high-risk patients (mean risk score: 6.58 ± 0.93). Results: Predicted and actual mortality in all patients were 2.53 ± 1.63 and 3.75 (p = 0.376), respectively. Corresponding figures were as follows for specific risk groups: low-risk patients 1.38% ± 0.24 and 1.67% (p = 1), intermediate-risk patients 2.83% ± 0.8 and 4.35% (p = 0.722), high-risk patients 6.48% ± 1.55 and 15.38% (p = 0.668). When risk scores were analyzed in terms of operation type, predicted and actual mortality were 2.51 ± 1.74 and 3.11 (p = 1) for Group 1, and 2.29 ± 1.64 and 5.26 (p = 0.721) for Group 2, respectively. Area under the curve of 'Receiver Operating Characteristic' was 0.767 in all patients, 0.749 in Group 1 and 0.808 in Group 2. Conclusion: When predicted and actual mortality rates are analyzed, EuroSCORE scoring system seems to be an appropriate and easily applicable system for coronary artery bypass grafting and valvular operations in Turkish patient population.

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