Rodríguez Lima DR, Rodríguez Aparicio EE, Otálora González L, Hernández DC, González-Muñoz A. Performance of the EuroSCORE in coronary artery bypass graft in Colombia, a middle-income country: A retrospective cohort. World J Cardiol 2025; 17(3): 100506 [DOI: 10.4330/wjc.v17.i3.100506]
Corresponding Author of This Article
Edith Elianna Rodríguez Aparicio, MD, MSc, Medical Assistant, Researcher, Department of Critical Care, Hospital Universitario Mayor - Méderi, Cl. 24 #29-45, Bogota 111321, Colombia. edith.rodriguez@urosario.edu.co
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Mar 26, 2025; 17(3): 100506 Published online Mar 26, 2025. doi: 10.4330/wjc.v17.i3.100506
Performance of the EuroSCORE in coronary artery bypass graft in Colombia, a middle-income country: A retrospective cohort
David Rene Rodríguez Lima, Edith Elianna Rodríguez Aparicio, Laura Otálora González, Daniela Carolina Hernández, Alejandro González-Muñoz
David Rene Rodríguez Lima, Edith Elianna Rodríguez Aparicio, Department of Critical Care, Hospital Universitario Mayor - Méderi, Bogota 111321, Colombia
David Rene Rodríguez Lima, Laura Otálora González, Daniela Carolina Hernández, Alejandro González-Muñoz, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogota 111321, Colombia
Co-first authors: David Rene Rodríguez Lima and Edith Elianna Rodríguez Aparicio.
Author contributions: Rodríguez Aparicio EE and Rodríguez Lima DR contribute equally to this study as co-first authors; Rodríguez Aparicio EE wrote the manuscript; Rodríguez Lima DR directed the data analysis and interpretation and corrected the manuscript; Hernández DC, Otálora González L and González-Muñoz A collected data.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Universidad del Rosario (Comité de Investigación de la Universidad del Rosario Sala de Ciencias de la Vida), with approval number DVO005 1968-CV1550, in compliance with the Declaration of Helsinki and local ethical guidelines.
Informed consent statement: Informed consent was obtained from all subjects involved in the study, following the ethical guidelines established by the Institutional Review Board.
Conflict-of-interest statement: The authors declare no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: The data that support the findings of this study are available upon reasonable request from the corresponding author. Due to privacy or ethical restrictions, the data are not publicly available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Edith Elianna Rodríguez Aparicio, MD, MSc, Medical Assistant, Researcher, Department of Critical Care, Hospital Universitario Mayor - Méderi, Cl. 24 #29-45, Bogota 111321, Colombia. edith.rodriguez@urosario.edu.co
Received: August 18, 2024 Revised: October 24, 2024 Accepted: March 13, 2025 Published online: March 26, 2025 Processing time: 214 Days and 18.4 Hours
Abstract
BACKGROUND
The EuroSCORE II is a globally accepted tool for predicting mortality in patients undergoing cardiac surgery. However, the discriminative ability of this tool in non-European populations may be inadequate, limiting its use in other regions.
AIM
To evaluate the performance of EuroSCORE II in patients undergoing coronary artery bypass graft (CABG) surgery at a hospital in Bogotá, Colombia.
METHODS
An observational, analytical study of a retrospective cohort was designed. All patients admitted to Hospital Universitario Mayor Méderi who underwent CABG between December 2015 and May 2020 were included. In-hospital mortality was the primary outcome evaluated. Furthermore, the performance of EuroSCORE II was assessed in this population.
RESULTS
A total of 1009 patients were included [median age 66 years IQR = 59-72, 78.2% men]. The overall in-hospital mortality was 5.5% (n = 56). The median mortality predicted using EuroSCORE II was 1.29 (IQR = 0.92-2.11). Non-ST-segment elevation myocardial infarction was the most common preoperative diagnosis (54.1%), followed by ST-segment elevation myocardial infarction (19.1%) and unstable angina (14.3%). Urgent surgery was performed in 87.3% of the patients (n = 881). Mortality rates in each group were as follows: Low risk 6.0% (n = 45, observed-to-expected (O/E) ratio, 5.6), moderate risk 3.0% (n = 5, O/E ratio 1.17), high risk 5.0% (n = 4, O/E ratio 0.94), and very high risk 7.6% (n = 2, O/E ratio 0.71). The overall O/E ratio was 4.2. The area under the curve of EuroSCORE II was 0.55 [95% confidence interval: 0.48-0.63]
CONCLUSION
EuroSCORE II exhibited poor performance in this population owing to its low discriminative ability. This finding may be explained by the fact that the population comprised older individuals with higher ventricular function impairment. Moreover, unlike the population in which this tool was originally developed, most patients were not electively admitted for the surgery.
Core Tip: Evaluating the EuroSCORE II in specific populations is crucial owing to the significant discrepancies reported between observed and expected mortality rates. Accurate assessment tools are essential for understanding and alleviating mortality rates in hospitals in developing countries. Tailoring EuroSCORE II to local contexts can facilitate informed public health decisions, optimize resource allocation, and ultimately enhance patient outcomes within healthcare systems.
