Validación temporal del modelo EuroSCORE para la evaluación de los resultados de la cirugía de sustitución valvular mitral

Jean L. Chao García; Francisco J. Vázquez Roque; Roger Mirabal Rodríguez; Gustavo J. Bermúdez Yera; Ernesto Chaljub Bravo; Yury Medrano Plana; Noel L. Castillo García; Vielka González Ferrer; Yolepsis Quintero Fleites; José L. Valdés Cantero; Yoandy López de la Cruz; Luis A. González Borges; Álvaro L. Lagomasino Hidalgo; Deysi Rivero Valerón

Authors

Jean L. Chao García
Francisco J. Vázquez Roque
Roger Mirabal Rodríguez
Gustavo J. Bermúdez Yera
Ernesto Chaljub Bravo
Yury Medrano Plana
Noel L. Castillo García
Vielka González Ferrer
Yolepsis Quintero Fleites
José L. Valdés Cantero
Yoandy López de la Cruz
Luis A. González Borges
Álvaro L. Lagomasino Hidalgo
Deysi Rivero Valerón

Abstract

Introduction and Objectives: The preoperative surgical risk estimate can be made through mathematical models or clinical prediction scales. The objective was to validate the EuroSCORE in order to assess the immediate results of mitral valve replacement surgery. Method: Analytical, longitudinal study with a prospective follow-up of 158 patients who underwent surgery for mitral valve disease at the Cardiocentro Ernesto Che Guevara, in Villa Clara, from 2007 to 2010. EuroSCORE was calculated in all patients. Model calibration was assessed using the Hosmer-Lemeshow goodness of fit test. The discrimination capacity was analyzed by calculating the value of the area under the ROC curve. Results: The mean EuroSCORE was 2.1 with a standard deviation of 1.45. Expected mortality was 3.9%, lower than the actual mortality that was 4.4%. The deceased had a mean score of 5.9, and those who survived 1.95 (p = 0.00). Those who had serious complications showed a higher mean score than those who did not have them, 3.45 vs. 1.84; the diference is highly statistically significant (p = 0.000). The area under the ROC curve was 0.97, with a significance level of 0.000 for those who died, and the presence of serious complications with an area of 0.70 under the curve and a significance of 0.002. Conclusions: The EuroSCORE is reliable to predict early mortality in patients who have undergone mitral valve replacement surgery in our hospital. EuroSCORE did not predict early major morbidity.

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References

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