The European System for Cardiac Operative Risk Evaluation (EuroSCORE)

NOTE: This is the simplified version of the EuroSCORE. The full logistic model is available at www.euroscore.org.

Database: developmental dataset 13,302 patients; validation dataset 1,479.

Patient-related factors:

(1) age

(2) sex

(3) chronic pulmonary disease: long-term use of bronchodilators or steroids for lung disease

(4) extracardiac arteriopathy: one or more of the following (claudication; carotid occlusion or >50% stenosis; previous or planned intervention on the abdominal aorta, limb arteries or carotids)

(5) neurological dysfunction: severely affecting ambulation or day-to-day functioning

(6) history of previous cardiac surgery requiring opening of the pericardium

(7) serum creatinine, preoperative

(8) active endocarditis: patient still under antibiotic treatment for endocarditis at the time of surgery

(9) critical preoperative state: one or more of the following (ventricular tachycardia or fibrillation; aborted sudden death; preoperative cardiac massage; preoperative ventilation before arrival at the anesthetic room; preoperative inotropic support; intra-aortic balloon pump; preoperative acute renal failure with anuria or oliguria)

Cardiac-related factors:

(10) unstable angina: rest angina requiring IV nitrates until arrival in the anesthetic room

(11) left ventricular dysfunction

(12) recent myocardial infarction: within past 90 days

(13) pulmonary hypertension: systolic pulmonary artery pressure > 60 mm Hg

Operation-related factors:

(14) emergency surgery: carried out on referral before the beginning of the next working day

(15) surgery other than isolated CABG: major cardiac procedure other than or in addition to CABG

(16) surgery on the thoracic aorta: for disorder of the ascending, arch or descending aorta

(17) postinfarct septal rupture

where:

• The points for age are 1 point "per 5 years or part thereof over 60 years". I interpret this to mean that a fractional decimal is rounded to the next integer. For example, 66 years would be 6 years above 60 years, which is 1.2 of a 5-year-interval. This would be scored as 2 points (to include the "part thereof"). This is achieved in EXCEL with the ROUNDUP function.

EuroSCORE =

= SUM(points for all 17 parameters)

Interpretation:

• minimum score: 0

• maximum score: 37 + (points for age)

• The higher the score, the greater the mortality rate.