Biomedical and psychological risk in cardiac surgery: is EuroSCORE a more comprehensive risk measure than Stroke Index?
نویسندگان
چکیده
OBJECTIVE Several composite risk score indices, the most common being the Stroke Index and the European System for Cardiac Operative Risk Evaluation (EuroSCORE), have been developed to predict perioperative events such as cerebrovascular accidents or death. The main aim of the present study was to compare the preoperative associations between the Stroke Index or the EuroSCORE with anxiety, depression, memory, attention, and executive functions scores in patients undergoing cardiac surgery. METHODS Ninety-one patients were required to perform a preoperative psychological evaluation. Trail Making Test A and B (TMT A/B), Memory with 10 and 30s interference, Digit Span Test, Phonemic Fluency, State and Trait Anxiety Inventory (STAI Y1/Y2), and Center for Epidemiological Study of Depression Scale (CES-D) were administered. The Stroke Index and the EuroSCORE were also considered for each patient. Correlations between the Stroke Index or the EuroSCORE, mood, and neuropsychological scores were performed. RESULTS Seventy-seven patients completed the psychological evaluation. The Stroke Index was significantly correlated with TMT A (ρ=0.40, p=0.001), TMT B (ρ=0.38, p=0.001), Memory with 10s (ρ=-0.34, p=0.003) and 30s (ρ=-0.40, p=0.001) interference, and Phonemic Fluency (ρ=-0.29, p=0.01), but not with Digit Span Test (ρ=-0.18, p=0.13), STAI Y1 (ρ=0.08, p=0.44), STAI Y2 (ρ=0.06, p=0.56), and CES-D (ρ=0.11, p=0.31) scores. The EuroSCORE was significantly correlated not only with TMT A (ρ=0.49, p=0.001), TMT B (ρ=0.42, p=0.001), Memory with 10s (ρ=-0.23, p=0.04) and 30s (ρ=-0.35, p=0.002) interference, Phonemic Fluency (ρ=-0.28, p=0.01), and Digit Span Test (ρ=-0.28, p=0.01) but also with STAI Y1 (ρ=0.27, p=0.02), STAI Y2 (ρ=0.23, p=0.04), and CES-D (ρ=0.26, p=0.02). CONCLUSIONS While both the Stroke Index and the EuroSCORE account for the relationship between biomedical and cognitive risk factors in predicting perioperative risk, only the EuroSCORE also accounts for affective dysfunctions, which, in turn, have been proved to represent risk factors for perioperative adverse events. Therefore, compared with the Stroke Index, the EuroSCORE can be considered a more complete risk index in predicting perioperative risk. Data also suggest that a comprehensive preoperative evaluation of biomedical, mood, and cognitive performances might provide a more accurate mirror of the actual risk in patients undergoing cardiac surgery.
منابع مشابه
بررسی میزان کارایی سیستم یورواسکور در پیش بینی مرگ و میر یک ماهه بیماران تحت جراحی قلب
Background and purpose: Coronary artery bypass surgery (CABG) is an effective and important treatment for patients with coronary artery disease. In recent years there has been increasing interest in prediction of mortality and patient's outcome after cardiac surgery. Several models have been designed to identify related risk factors. This study aimed at evaluating EuroSCORE model in CABG patien...
متن کاملThe prospective validation of EuroSCORE II risk scoring system for patients underwent cardiac surgery: brief report
Background: Various prediction models have been developed aiming to estimate risk-adjusted mortality, morbidity and length of intensive care unit stay following cardiac surgeries. The European system for cardiac operative risk evaluation II (EuroSCORE II) is a prediction model which maps 18 predictors to a 30-day post-operative risk of death. The objective of this study was to evaluate the perf...
متن کاملFrailty effects and euro score system evaluation in postoperative outcomes of cardiac surgery patients
Background: Several scoring systems are available to evaluate the cardiac surgery risk. Frailty increases the risk of adverse outcomes after surgery. The Frailty evaluation system is a relatively new method, and in this study, we compared the frailty scoring method with the conventional Euroscore method. Methods: This cross-sectional study was performed on 88 elderly patients (over 65 years of...
متن کاملبررسی اپیدمیولوژیک عوامل خطر اصلی سکته های مغزی در بیماران مراجعه کننده به بیمارستان فرشچیان همدان در سال 1393
Introduction & Objective: Stroke is the third cause of death in developed countries and the most common neurologic disease resulting in disability. Nowadays, several risk factors for stroke are recognized properly. Life style and risk factors such as hypertension and diabetes are different among various cultures and countries. This study was designed to evaluate strokes epidemiology and their c...
متن کاملEffect of Bady Mass Index on patients prognosis after heart surgery
Introduction: Patients with high or low body mass index may be more at risk of death and complications after surgery, especially in patients who have coronary artery bypass grafting may be the outcome could be more specific, so we decided to evaluate effect BMI and its correlation with survival and outcome in cardiac surgery. Methods: A Cross sectional study of 345 patients who underwent sur...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
دوره 39 5 شماره
صفحات -
تاریخ انتشار 2011