The validation of EuroSCORE Ⅱ in predicting the mid-term outcome of patients undergoing Sun's procedure for Stanford type A dissection / 中华胸心血管外科杂志

ABSTRACT

Objective EuroSCORE is a widely used objective risk scoring model.The aim of this study was to evaluate the validation of EuroSCORE Ⅱ in predicting mid-term survival after total aortic arch replacement with stented elephant trunk implantation(sun' s procedure) for Stanford Type A aortic dissection.Methods Total 90 patients entered the study randomly.All the patients underwent aortic surgery using total aortic arch replacement with stented elephant trunk implantation (Sun's procedure).The patients were divided into three groups based on the predicting mortality by EuroSCORE Ⅱ.Ggroup 1:0 ＜:P ≤ 5 ％,Group 2:5 ％ ＜ P ≤ 10％,Group 3:P ＞ 10％.Kaplan-Meier method was used to evaluate the long term survival of three groups.Receiver operating characteristic curve was used to test discrimination of the EuroSCORE.Calibration was assessed with a Hosmer-Lemeshow goodness-offit statistic.Results 87 patients were followed umil October,2013.The mean follow-up time was(33.32 ± 11.11) months.Total 5 patients died during the follow-up time.Three patients died in group 1,2 patients died in group 2 and 1 in group 3.There was no statistical difference for the mid-term survival rate between 3 groups (P =0.054).Conclusion Although EuroSCORE Ⅱ is the newest risk model for cardiac surgery,it is not accurate when it is applied for predicting mid-term survival after aortic surgery.A new risk evaluating system specially designed for aortic surgery should be developed in the future.