STS Score and EuroSCORE II Difference in Cardiac Patient Prognostic Evaluation
Mustafayev, Murad |
Recenzentas / Reviewer | |
Komisijos pirmininkas / Committee Chairman | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member |
Aim: A comparison of EuroSCOREII and STS risk score models in prognostic accuracy of mortality risk of cardiac patients.
Objectives: 1. To review the risk assessment models used in cardiac surgery; 2. To compare the accuracy of mortality assessment scales STS and EuroSCOREII in predicting the risk of death after cardiovascular interventions they share; 3. To differentiate the variables and parameters of STS score from EuroSCOREII in a range of different procedures that they share.
Methodology: The literature review is based on publications evaluating the diagnostic performance of EuroSCORE II and STS risk score in a range of procedures in which they share. To find these studies, keywords were inputted into scientific search engines: EuroSCORE II and STS risk score in adult population, accuracy and difference in parameters. Objective-specific inclusion and exclusion criteria were applied to select among various articles. All related papers and reference lists from the original publications on this topic were also examined.
Results: Literature analysis was made in three phases. The first phase revealed 637 articles which utilized STS and EuroSCORE II as keywords. In the second phase, after applying the inclusion/exclusion criteria; 21 articles were dedicated to review risk assessment models in cardiac surgery while 12 articles were analyzed to review the accuracy of STS and EuroSCORE II in a range of procedures that they share. In the last phase, the parameters of both risk scores were reviewed from the official websites of the organizations to whom these scores belong to. The impact of certain parameters on accuracy and mortality was analyzed from the 12 studies, two of which were dedicated to isolated CABG, TAVI and mixed procedures. Three were assigned to isolated AVR and AVR + CABG procedures, and one study designated to TAVR.
Conclusion: In the review of risk models used in cardiac surgery, it has been found that STS and EuroSCORE II portrayed a finer efficacy but were slightly different from each other in their prognostic ability.
Both scores were accurate in their mortality assessments. STS revealed a better prognosis of mortality risk in the elderly, whereas EuroSCORE II had significantly better prognostic ability in the younger demographic.
The differentiation between the scores exhibited that STS has more parameters than EuroSCORE II. EuroSCORE II presented with better accuracy in patients undergoing isolated CABG and AVR procedures. STS score has seemingly adequate performance in population receiving combined valve + CABG but it is not greatly substantiated. Both scores were unreliable to estimate accurate mortality for patient receiving TAVI or TAVR.
Practical recommendations: It is suggested to use EuroSCORE II rather than STS in younger demographics undergoing isolated CABG and AVR procedures. Nevertheless, in patients presenting with a critical state undergoing urgent surgery, both risk scores tend to estimate mortality inaccurately. The final treatment decision in urgent and complicated cases should be established by a multidisciplinary cardiac team when the hospital’s resources are available.
Tikslas: Palyginti EuroSCORE II ir STS rizikos vertinimo skalių tikslumą, vertinant širdies ligomis sergančių ligonių mirtingumo riziką.
Tikslai:1. Apžvelgti širdies chirurgijoje taikomus rizikos vertinimo modelius; 2. Palyginti rizikos vertinimo skalių STS ir EuroSCOREII tikslumą prognozuojant mirties riziką po kardiovaskulinių intervencijų, kuriose jos abi panaudotos; 3. Atskirti STS rizikos vertinimo skalės kintamuosius ir parametrus nuo EuroSCORE II taikant įvairias procedūras, kuriose jie abu panaudoti.
Metodologija: Literatūros apžvalga, pagrįsta publikacijomis, kuriose vertinamas EuroSCORE II ir STS rizikos skalių diagnostinis efektyvumas atliekant įvairias procedūras.
Rezultatai: Literatūros analizė buvo atlikta trimis etapais. Pirmajame etape buvo atskleisti 637 straipsniai, kuriuose kaip raktiniai žodžiai buvo naudojami STS ir EuroSCORE II. Antrajame etape, pritaikius įtraukimo/išskyrimo kriterijus, 21 straipsnis buvo skirtas širdies chirurgijos rizikos vertinimo modeliams apžvelgti. 12 straipsnių buvo išanalizuoti, siekiant peržiūrėti STS ir EuroSCORE II tikslumą atliekant įvairias bendras procedūras.
Išvada: Peržiūrint rizikos modelius, naudojamus širdies chirurgijoje, buvo nustatyta, kad STS ir EuroSCORE II rizikos vertinimo skalės buvo plačiausiai naudojamos širdies chirurgijoje .Abi rizikos vertinimo skalės buvo tikslios vertinant mirtingumą. STS atskleidė geresnę vyresnio amžiaus žmonių mirtingumo rizikos prognozę, o EuroSCORE II turėjo geresnį prognostinį efektyvumą jaunesnio amžiaus žmonėms. Abi rizikos vertinimo skalės nebuvo tiek patikimos, kad būtų galima tiksliai apskaičiuoti mirtingumą, atliekant perkateterinius aortos vožtuvo implantavimus.