About the "logistic" euroSCORE
Two risk calculators are available on this website: the simple additive EuroSCORE and the full logistic EuroSCORE. The reason for having both is explained below.
The simple additive EuroSCORE model is now well established and has been validated in many patient populations across the world. It is easy to use, even at the bedside. It is very valuable in quality control in cardiac surgery and gives quite a useful estimate of risk in individual patients. However, particularly in very high risk patients, the simple additive model may sometimes underestimate the risk when certain combinations of risk factors co-exist. The full logistic version of EuroSCORE produces more accurate risk prediction for a particular high risk patient. Its main disadvantage is that the risk has to be calculated in quite a complex way - not by mental arithmetic or "on the back of an envelope".
You are invited to try out both models and to use the one most suitable to your practice.
By selecting "Standard euroSCORE" euroSCORE values are simply added to estimate risk of death as described in Roques F, Nashef SA, et al. Eur J Cardiothorac Surg. 1999 Jun;15(6):816-22
By selecting "Logistic euroSCORE" - euroSCORE predicted mortality is calculated as described in Roques F, Michel P, Goldstone AR, Nashef SA. Eur Heart J. 2003 May;24(9):882-3
Predicted mortality = e (β0 + åbi Xi) / 1+ e (β0 + åbi Xi)
Click here for full details on how to calculate Logistic euroSCORE. [Calculator version 1.9 Updated 28th April 2003]
Notes
[1] Chronic pulmonary disease Long term use of bronchodilators or steroids for lung disease
[2] Extracardiac arteriopathy One or more of claudication, carotid occlusion or >50% stenosis, previous or planned intervention on the abdominal aorta, limb arteries or carotids
[3] Neurological dysfunction Disease severely affecting ambulation or day-to-day functioning
[4] Active endocarditis Patient still on antibiotic treatment for endocarditis at time of surgery
[5] Critical preoperative state Ventricular Tachycardia / Ventricular Fibrillation or aborted sudden death, preoperative cardiac massage, preoperative ventilation before anaesthetic room, preoperative inotropes or IABP, preoperative Acute Renal Failure (anuria or oliguria <10ml/hr)
[6] Unstable angina Rest angina requiring i.v. nitrates until arrival in anaesthetic room
[7] Recent MI Myocardial infarction within 90 days
[8] Pulmonary hypertension Systolic pulmonary artery pressure >60mmHg
[9] Emergency Operation before beginning of next working day
You may also download a calculator for use offline.
References and other resources
Roques F, Nashef SA, Michel P, Gauducheau E, de Vincentiis C, Baudet E, Cortina J, David M, Faichney A, Gabrielle F, Gams E, Harjula A, Jones MT, Pintor PP, Salamon R, Thulin L. Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients. Eur J Cardiothorac Surg. 1999 Jun;15(6):816-22; discussion 822-3.
Roques F, Michel P, Goldstone AR, Nashef SA. The logistic EuroSCORE. Eur Heart J. 2003 May;24(9):882-3
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