Background and Objectives:
This study aims to determine whether adding preoperative hemoglobin, B-type natriuretic peptide (BNP) or both to the logistic EuroSCORE (European System for Cardiac Operative Risk Evaluation) would increase its predictive power for in-hospital and 6-month morbidity and mortality.
Four hundred and ninety-two (492) patients were included in the study. The predictive power of hemoglobin and/or B-type natriuretic peptide was compared vs. EuroSCORE. Then, the degree to which the incorporation of these two variables into EuroSCOREhelpedto achieve better discrimination was evaluated.
The in-hospital and 6-month mortality were well discriminated by EuroSCORE alone. The inclusion of hemoglobin or B-type natriuretic peptide had no added effect on the predictive power of the model. The discrimination obtained with B-type natriuretic peptide alone was good for the postoperative low cardiac output and acute renal failure. EuroSCORE also showed good predictive power for morbidity.Regarding the in-hospital morbidity, the discrimination obtained with the B-type natriuretic peptide alone was not significantly different from that obtained with EuroSCORE. The addition of hemoglobin and B-type natriuretic peptide to EuroSCORE significantly improved the discrimination of those patients who will need a postoperative transfusion. A simple model, including only hemoglobin and B-type natriuretic peptide, had a good predictive power for the postoperative transfusion.
Hemoglobin and/or B-type natriuretic peptide showed no additional predictive power for the mortality when they were added to EuroSCORE. Regarding the morbidity, the discrimination obtained with B-type natriuretic peptide alone is comparable to that obtained with EuroSCORE. The addition of hemoglobin and B-type Natriuretic peptide to EuroSCORE results in a model with a good predictive power for a transfusion requirement.
B-type natriuretic peptide, hemoglobin, cardiac surgery, transfusions, postoperative care, EuroSCORE
Hernández E, Dennis R, Rada F, et al. Can the Predictive Power of Euroscore Be Improved by Adding Preoperative Hemoglobin or B-type Natriuretic Peptide (BNP) Values?. J Heart Surg Treatment. 2014;1(1):1-15.