Abstract:
OBJECTIVES:EuroSCORE II, despite improving on the original EuroSCORE system, has not solved all the calibration and predictability issues. We investigated the sensitivity, specificity and predictability of original EuroSCORE and EuroSCORE II system in elderly patients. METHODS:The original logistic EuroSCORE and EuroSCORE II were assessed via receiver operator characteristic (ROC) and Hosmer-Lemeshow test probability analysis with regard to accuracy of predicting in-hospital mortality. Analysis was performed on isolated coronary artery bypass graft (CABG) (n = 2913), aortic valve replacement (AVR) (n = 814), mitral valve surgery (MVR) (n = 340), combined AVR and CABG cases (n = 517) and the above cases combined (n = 4584). Elderly was defined as ≥70 years old. Age <70 was used for comparative purposes. RESULTS:Institutional mortality was 2.9%, for all isolated CABG, AVR, MVR and combined AVR and CABG cases. In all patients aged ≥70 neither the original EuroSCORE nor EuroSCORE II had a ROC c-statistic above 0.7. For isolated CABG, the ROC c-statistic was not acceptable in patients ≥70 years of age, but was fine for patients under the age of 70 years. For isolated AVR the ROC c-statistic was good for patients aged less than 70 years of age for both risk models; however, the ROC was unacceptably low in patients aged ≥70 for both models. For isolated MVR, the ROC c-statistic and Hosmer-Lemeshow test probability was good for all patients regardless of age. For combined AVR and CABG, the ROC c-statistic was unacceptably low for all patients, regardless of age group using the original EuroSCORE, and in those aged ≥70 using the EuroSCORE II risk model. The original EuroSCORE had no issues with the Hosmer-Lemeshow test probability; however, EuroSCORE II had poor model predictability for all patients, P < 0.0001, and for isolated CABG, P = 0.05 and AVR, P = 0.06. CONCLUSIONS:The original EuroSCORE and the EuroSCORE II risk models should be used with caution in patients aged 70 or older undergoing cardiac surgery in the modern era. Below the age of 70, both models are sensitive, specific and have good predictive power. Our work needs validation by other large groups.
journal_name
Interact Cardiovasc Thorac Surgjournal_title
Interactive cardiovascular and thoracic surgeryauthors
Poullis M,Pullan M,Chalmers J,Mediratta Ndoi
10.1093/icvts/ivu345subject
Has Abstractpub_date
2015-02-01 00:00:00pages
172-7issue
2eissn
1569-9293issn
1569-9285pii
ivu345journal_volume
20pub_type
杂志文章abstract:OBJECTIVES:Concomitant surgical ablation of atrial fibrillation (AF) is recommended for patients undergoing off-pump coronary revascularization in the presence of this arrhythmia. Achievement of optimal visualization of pulmonary veins while maintaining stable haemodynamic conditions is crucial for proper completion of...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx026
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:Optimal management of patients with combined coronary and carotid artery disease remains controversial. This study analyzed the outcomes between simultaneous carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) vs. isolated CABG. METHODS:We reviewed the early and late follow-up data of 412...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2005.114678
更新日期:2006-04-01 00:00:00
abstract::A 68-year-old man presented with destruction of his sternum after cardiac surgery. Classical management with multiple debridements, vacuum dressings and antibiotics failed. A replacement of his sternum was performed using an antibiotic-loaded porous alumina ceramic sternum. Despite the infected wound, the ceramic ster...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivz182
更新日期:2019-12-01 00:00:00
abstract::This study presents a novel way to perform the mini-maze procedure through the left atrial appendage. By this way, the usual additional incision of the intra-atrial groove is avoided, especially in patients receiving coronary artery bypass grafting (CABG) or aortic valve replacement without mitral valve disease. We re...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivu035
更新日期:2014-06-01 00:00:00
abstract::A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: in patients with hypertrophic and keloid scarring of the sternotomy wound, is surgical excision with or without adjuvant treatment of any benefit in reducing the size of the scar? Altogether, more than ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1510/icvts.2010.264887
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVES:In cardiac surgery, adequate heparinization is necessary to prevent thrombus formation in the cardiopulmonary bypass (CPB). To counteract the heparin effect after weaning from CPB, protamine is administered. The optimal protamine/heparin ratio is still unknown. METHODS:In this before-after study, we evaluat...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivaa109
更新日期:2020-09-01 00:00:00
abstract::Commonly used extracorporeal membrane oxygenation (ECMO) systems for cardiac support are limited by bleeding complications, especially after surgery in the adult patient. Recently, we have switched from the use of a conventional ECMO system to a miniature-circuit including a centrifugal pump and the Novalung membrane ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.209783
更新日期:2009-11-01 00:00:00
abstract::Early repair of postinfarction ventricular septal rupture is usually associated with significant mortality and morbidity. Assessing conditions to moderately delay the surgical intervention and reduce cardioplegic arrest may be an interesting approach to improve hospital results. Results of five non-selected patients i...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2004.100255
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVES:The optimal management and treatment of pericardial effusion are still controversial. There is limited data related to the risk factors affecting survival in these patients. The aim of this study was to determine the risk factors affecting the survival rate of patients with symptomatic pericardial effusion w...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs491
更新日期:2013-04-01 00:00:00
abstract::Lung cancer is the leading cause of cancer-related death worldwide. For early stages of the disease, lung resection surgery remains the best treatment with curative intent, but significant morbidity is associated, especially among patients with poor pulmonary function and cardiorespiratory fitness. In those cases, the...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1093/icvts/ivw152
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVES:Postinfarction ventricular septal defect is a serious mechanical complication of acute myocardial infarction associated with high postoperative mortality. The aim of this study was to review our experience with surgical repair of postinfarction ventricular septal defect and to identify predictors of early an...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx230
更新日期:2018-01-01 00:00:00
abstract::A 51-year-old female patient was admitted to our department. She had symptoms of dysphagia, regurgitation of a fleshy mass into the mouth, and attacks of dyspnea. Every effort was made for diagnosis. At cervical exploration, upper esophageal polyp was discovered incidentally, and removed. We present this case because ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1016/j.icvts.2003.11.013
更新日期:2004-06-01 00:00:00
abstract::An aorto-oesophageal fistula is a rare, life-threatening complication caused by sharp foreign bodies in the oesophagus. We report an aorto-oesophageal fistula in the inferior segment of thoracic oesophagus caused by a fish bone. Multiplanar reconstruction of computed tomography and computed tomography angiography demo...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivx362
更新日期:2018-03-01 00:00:00
abstract::Platelet dysfunction followed by thromboembolic as well as bleeding complications are severe events in patients with ventricular assist devices (VADs). Microparticles (MP) are cell vesicles with inflammatory and coagulatory potency that are released by cells during activation and can be used as specific cell activatio...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.232603
更新日期:2010-08-01 00:00:00
abstract::OBJECTIVES Video-thoracoscopic surgery (VTS) has been accepted as a safe and credible technique since 1990. Lung injury is one of the main perioperative complications. Few data are available about cardiac trauma and VTS-related false aneurysm of the left ventricular (LV) wall has not yet been reported. METHODS A 62-y...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs119
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:In the belief that stress is the main determinant of leaflet quality deterioration, we sought to evaluate the effect of annular and/or sino-tubular junction dilatation on leaflet stress. A finite element computer-assisted stress analysis was used to model four different anatomic conditions and analyse the co...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivt116
更新日期:2013-07-01 00:00:00
abstract::We present a case of a 58-year-old male with a recurrent left ventricular pseudoaneurysm. Two years before, the patient underwent repair of an apical aneurysm with a thrombus, which was very likely infected and complicated by huge pseudoaneurysm. The dramatic presentation of the recurrent pseudoaneurysm, as it invaded...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivaa097
更新日期:2020-09-01 00:00:00
abstract::We recently reported the feasibility of a handmade left atrioventricular valve using decellularized extracellular matrix for 3 months in a failed repair of AV canal defect. We present the use of an extracellular matrix mitral valve for 9 months in an infant with an un-repairable congenitally malformed valve. The valve...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw406
更新日期:2017-04-01 00:00:00
abstract::We investigated the prevalence, risk factors, and optimal timing of treatment for advanced periodontitis in patients undergoing elective heart valve surgery. Dental examinations were given to 209 patients (aged 65 ± 10 years) scheduled for valve surgery. Patients with no or mild periodontitis were assigned as controls...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2010.255943
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVES:This study compares the uniportal with the 3-portal video-assisted thoracic surgery (VATS) by examining the data collected in the Italian VATS Group Database. The primary end point was early postoperative pain; secondary end points were intraoperative and postoperative complications, surgical time, number of...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,多中心研究
doi:10.1093/icvts/ivz153
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVES:Postoperative infections are still an important problem in cardiac surgery, especially in the paediatric population, and may influence the final outcome of congenital heart disease treatment. Postoperative infections with fungi are uncommon. The aetiology is poorly understood, and the proper diagnosis and tr...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivw156
更新日期:2016-09-01 00:00:00
abstract::Reconstructions of the chest wall using commercially available artificial metallic rib systems are gaining in popularity. The MatrixRib system involves use of plates and screws to bridge any defect and provide support for the chest wall following resection. So far, there has been no publication focusing on describing ...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivt515
更新日期:2014-03-01 00:00:00
abstract::A 66-year-old female underwent elective coronary artery bypass grafting (CABG). Massive pulmonary embolism developed intraoperatively shortly after weaning from cardiopulmonary bypass. A 25-cm large venous embolus was extracted from pulmonary artery by consequently performed open pulmonary embolectomy on the beating h...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2005.107433
更新日期:2005-08-01 00:00:00
abstract::We report the case of a 55-year-old woman with thymoma diagnosed after finding of extra limbic encephalitis. She presented neurologic symptoms as seizure and aphasia; magnetic resonance imaging (MRI) of the brain showed multiple lesions located in insular, parietal and temporal lobes (in cortical and sub-cortical area...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.211276
更新日期:2009-10-01 00:00:00
abstract::We report on a patient with Marfan syndrome who presented a Stanford type B dissection of the descending thoracic aorta in late pregnancy. After a cesarean section, the patient presented a severe obstruction of the mesenteric superior artery. An endovascular fenestration was performed (balloon and guidewire based fene...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.232124
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVES:The anti-fibrillatory effect of potassium is well recognized from experimental models. There have, however, been very few clinical reports on the use of potassium to convert ventricular fibrillation (VF) after cardioplegic arrest. METHODS:In total, 8465 adult patients undergoing cardiac operations on cardio...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivs455
更新日期:2013-02-01 00:00:00
abstract::A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was does prophylactic inhaled nitric oxide (NO) reduce morbidity and mortality after lung transplantation? Altogether 232 papers were found using the reported search, of which six represented the best evide...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章,评审
doi:10.1510/icvts.2011.274365
更新日期:2011-11-01 00:00:00
abstract::Bicuspid aortic valve (BAV) is currently considered an exclusion criterion for transcatheter aortic valve implantation (TAVI). The risk of adverse aortic events such as incomplete sealing, severe paravalvular regurgitation or dislocation due to elliptic shape and asymmetric calcifications in annulus are higher in TAVI...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivv226
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVES:Bowel ischaemia following cardiac surgery is associated with a high postoperative mortality. No scoring system exists as yet to predict this complication following surgery. In addition, the long-term survival is not known. We sought to evaluate in-hospital outcomes and long-term outcomes in bowel ischaemia f...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1093/icvts/ivv148
更新日期:2015-09-01 00:00:00
abstract::Plombage, a variant of collapse therapy for patients with pulmonary tuberculosis that uses a variety of foreign materials, was undertaken until the 1950s before the invention of effective antimicrobial therapy. Complications related to previous plombage procedures are not uncommon. Management of these complications ca...
journal_title:Interactive cardiovascular and thoracic surgery
pub_type: 杂志文章
doi:10.1510/icvts.2009.220699
更新日期:2010-05-01 00:00:00