COMPARISON OF EURO SCORE II (EUROPEAN SYSTEM FOR CARDIAC OPERATIVE RISK EVALUATION) AND STS (SOCIETY OF THORACIC SURGERY) RISK MODELS IN PREDICTING OUTCOMES OF CARDIAC SURGERY IN EGYPTIAN CARDIAC PATIENTS

Objectives: This study was carried out to analyze patient data both in retrospective and prospective design comparing the European System for Cardiac Operative Risk Evaluation (Euro SCORE II) and Society of Thoracic Surgeons (STS) risk models in Egyptian cardiac surgical patients. Methods: Computerized registries of all patients having cardiac surgery at NASSER Institute Hospital (one of the major specialized tertiary level hospital in Egypt) were used to identify and capture patients’ data. A total of 1238 patients were evaluated against both tools where Euro SCORE II and STS values had been calculated. The area under receiver operating characteristic (ROC) curve, was used to represent the discriminative power of the scoring system and Hosmer-Lemeshow statistic was used to assess calibration. Results: The in-hospital observed mortality was 21/1238 (1.7 %). The area under curve (AUC) for STS in predicting mortality was 0.652, While AUC for Euro SCORE II was 0.639. Both Euro Score II and STS showed good calibration. The AUC statistics for STS in predicting morbidity was 0.589, while it was 0.603 for Euro SCORE II. STS showed good calibration compared to Euro Score II in predicting mortality. But unfortunately, Euro Score II showed failure of calibration (P= 0.004). Conclusion: Both STS & Euro Score II demonstrated moderate discriminant ability in predicting mortality with good calibration. Euro Score II showed better discriminant ability in predicting morbidity than STS, but Euro Score II showed failed calibration. Euro Score II showed more specificity than STS in predicting mortality and morbidity.