does EuroSCORE mean?
Why do we need this?
Operative mortality is a good measure of quality of cardiac surgical care, as long as patient risk factors are taken into consideration. EuroSCORE is a method of calculating predicted operative mortality for patients undergoing cardiac surgery.
How was it developed?
Nearly 20 thousand consecutive patients from 128 hospitals in eight European countries were studied. Information was collected on 97 risk factors in all the patients. The outcome (survival or death) was related to the preoperative risk factors. The most important, reliable and objective risk factors were then used to prepare a scoring system. The scoring system was prepared from part of the database and tested and validated on another part. This scoring system is EuroSCORE.
Has it been tested elsewhere?
Yes. An increasing number of European hospitals have tested EuroSCORE on their own patients and against other scoring systems. It is performing very well. Recently, the national British database was used to test EuroSCORE; it outperformed other simple scoring systems and approached Bayesian models in discrimination power. You can see a selection of references here.
Where can I find out more?
The original papers on EuroSCORE were presented at the Brussels 1998 meeting of the European Association for Cardio-Thoracic Surgery. The key paper can be downloaded in PDF format. You can see the other references here.
How does the scoring system work?
It is simple. If a risk factor is present in a patient, a weight or number is assigned. The weights are added to give an approximate percent predicted mortality. You can try the system for yourself with our interactive calculator (available in six languages; English, Spanish, German, Italian, Finnish & French) or download a calculator for use offline.
So what is logistic euroSCORE ?
The simple additive EuroSCORE model is now well established and has been validated in many patient populations across the world. It is easy to use, even at the bedside. It is very valuable in quality control in cardiac surgery and gives quite a useful estimate of risk in individual patients. However, particularly in very high risk patients, the simple additive model may sometimes underestimate the risk when certain combinations of risk factors co-exist. The full logistic version of EuroSCORE produces more accurate risk prediction for a particular high risk patient. Its main disadvantage is that the risk has to be calculated in quite a complex way - not by mental arithmetic or "on the back of an envelope".
You are invited to try out both models and to use the one most suitable to your practice.