Long-term survival after coronary artery bypass surgery stratified by euroSCORE

Abstract

Objectives: Coronary artery bypass grafting (CABG) is performed for symptoms and for prognostic reasons. The EuroSCORE is widely utilized as a pre-operative risk prediction tool. We evaluated our long-term survival figures based on EuroSCORE. Methods: A prospective database was retrospectively analysed and cross correlated with the UK strategic tracking service to evaluate survival after primary CABG. Patients were grouped based on their logistic EuroSCORE 0 to <5, 5 to <10, 10 to <15, 15 to <20, 20 to <25 and ≥25. Results: We analysed 13 337 primary cardiac procedures. A total of 9961 procedures had a logistic EuroSCORE of 0 to <5, 2041 of 5 to <10, 636 of 10 to <15, 281 of 15 to <20, 137 of 20 to <25 and 281 ≥25. Long-term survival is significantly affected by logistic EuroSCORE, P < 0.001. Patients with a logistic EuroSCORE <5% had significantly better initial survival and a lower rate of death over a 10-year period, P < 0.001. Patients with a logistic score over 25 had a significantly worse 5-year survival, P < 0.001. Logistic EuroSCORE was poor at predicting survival when > 5 and < 25. Cox multivariate regression and neuronal network analysis confirmed that the additional factors, diabetes, body mass index (BMI), post-operative myocardial creatinine kinase myocardial isoenzyme (CKMB) and left internal mammary artery (LIMA) usage, which are not incorporated in EuroSCORE significantly predict long-term survival. Conclusions: Logistic EuroSCORE is a reasonable approximation for long-term survival after CABG, if the score is <5; however, its predictive capacity is limited due to the absence of LIMA usage, BMI, diabetes and CKMB in its calculation, all of which are significant factors affecting long-term survival. © The Author 2012. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.