EuroSCORE and Mortality–Morbidity Assessment in CABG Patients Aged ≥70 Years
EuroSCORE and Mortality in CABG ≥70 Years
DOI:
https://doi.org/10.5281/zenodo.19242313Keywords:
Elderly patients, Coronary bypass, EuroSCORE, Mortality, MorbidityAbstract
Aim: With the growing elderly population, coronary artery disease and the need for coronary artery bypass grafting (CABG) have increased substantially. Accurate preoperative risk stratification is crucial in this age group. Although EuroSCORE is widely used to predict perioperative mortality, its performance in elderly patients remains debated. This study aimed to evaluate the predictive accuracy of the EuroSCORE and to identify additional non-EuroSCORE factors associated with mortality and morbidity in patients aged ≥70 years undergoing CABG.
Materials and Methods: This retrospective study included 393 patients aged 70 years or older who underwent CABG in our clinic. Standard and logistic EuroSCORE values were calculated, and predicted vs. observed mortality rates were compared. Operative and postoperative outcomes were analyzed. Statistical analyses included Student’s t-test, Chi-square test, Fisher’s exact test, Mann–Whitney U test, ANOVA, and ROC analysis. A p-value <0.05 was considered significant.
Results: Of the patients, 58.3% were classified as high risk, with female sex, COPD, extracardiac arteriopathy, neurological sequelae, recent MI (<90 days), and reduced ejection fraction occurring more frequently in this group (p<0.05). The 30-day mortality rate was 7.63%, with mortality significantly higher in the high-risk group (10.5% vs. 3.7%; p=0.012). Predicted mortality using logistic EuroSCORE did not differ significantly from observed rates (p>0.05). ROC analysis demonstrated good discriminative ability (AUC=0.753). Non-EuroSCORE predictors associated with mortality included preoperative heart failure, prolonged cardiopulmonary bypass and cross-clamp times, and postoperative myocardial infarction. Hypertension, diabetes mellitus, cerebrovascular disease, and heart failure contributed to increased morbidity.
Conclusion: EuroSCORE provides reliable mortality prediction in elderly CABG patients; however, risk assessment in this population should not rely solely on scoring systems. Incorporating multimodal clinical parameters—such as frailty, organ dysfunction, and perioperative physiological reserve—offers a more comprehensive evaluation and may improve surgical decision-making.
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