Avaliação do EuroSCORE como preditor de mortalidade em cirurgia de revascularização miocárdica no Instituto do Coração de Pernambuco

OBJECTIVE: To assess the applicability of the European Risk System in Cardiac Operations (EuroSCORE) in patients undergoing myocardial revascularization at the Heart Institute of Pernambuco. METHOD: During 2003 and 2004, 759 patients underwent myocardial revascularization. Of these, seven were excluded owing to the lack of information on one aspect or another involved in obtaining a EuroSCORE. In order to assess the applicability of the EuroSCORE, an adjustment was made using a logistic regression model of operative mortality (response variable) on the EuroSCORE (explanatory variable). The calibration of the model was measured by comparing the morbidity observed with that expected, using the Hosmer-Lemeshow Test of Goodness of Fit. The accuracy of the model was evaluated by means of Statistic-c. RESULTS: The accuracy of the model, estimated at 69.9%, and the calibration (Hosmer-Lemeshow test, p=0.663) were satisfactory. The total predicted mortality was practically identical to that observed - 1.7%. The low-risk group (EuroSCORE: 0-2) comprised 231 patients and two (0.87%) deaths occurred. The medium-risk group (EuroSCORE: 3-5) comprised 268 patients and one (0.37%) death occurred. The high-risk group (EuroSCORE: > 6) comprised 253 patients and ten (3.95%) deaths occurred. The discrepancies between the percentages of deaths observed in these groups and those predicted by the model were not statistically significant on the basis of the result of the chi-square test (p=0.624). CONCLUSION: The EuroSCORE, a simple and objective index, proved to be a satisfactory predictor of operative mortality in patients submitted to myocardial revascularization in the Heart Institute of Pernambuco.