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Editorial comment

What to do with EuroSCORE in 2009?

Papworth Hospital, Cambridge CB23 3RE, UK

^_* Corresponding author. Tel.: +44 1480364299; fax: +44 1480364744. (Email: sam.nashef@papworth.nhs.uk).

Key Words: EuroSCORE • Risk assessment • Cardiac surgery

The first 20% of the full text of this article appears below.

In this issue [1], Nissinen and co-workers have attempted to improve the accuracy of EuroSCORE (logistic and additive) by developing a new model which takes some of the EuroSCORE variables and modifies others. This is based on fewer than 4000 patients in one institution.

The authors have been accurate in identifying the areas where EuroSCORE can be improved (lack of sufficient attention to the ‘weight’ of the intervention, use of simple creatinine rather than estimated glomerular filtration or creatinine clearance for assessing renal function, some relatively subjective variables, etc.). They have produced a new model which has better calibration and very slightly better discrimination when compared to EuroSCORE as applied to their patient population.

Although the paper purports to recommend improvements to the accuracy of EuroSCORE, it is in fact a new proposed risk model, and it therefore should be approached with rigour if it is to be taken seriously by the cardiac surgical . . . [Full Text of this Article]