The relationship between euroscore kidney functions and mortality in patients undergoing open heart surgery

Introduction The purpose of this study, it is to determine the relationship between EuroSCORE renal function and mortality in the group of adult patients undergoing open heart surgery in our clinic and evaluate appropriate of EuroSCORE system to patient population in our country. Materials and Methods After the hospital scientific ethical committee approval, Akdeniz University Faculty of Medicine, Department of Cardiovascular Surgery between January 1, 2009 and December 31, 2009 adult patients older than 18 years who underwent open heart surgery with cardiopulmonary bypass were analyzed retrospectively. 234 of evaluated 438 patients are the patients undergoing open heart surgery. The study included 216 of them. Because 18 cases are performed off-pump CABG, children and others were excluded for being non- cardiopulmonary bypass operations. Patients undergoing congenital heart surgery, performed off-pump coronary artery bypass surgery patients and patients undergoing cardiac transplantation were not included in the study. Obtained from the patient data, EuroSCORE risk calculation program (downloaded from the internet http://www.euroscore.org) for each patient with for both standard EuroSCORE and logistic EuroSCORE models were calculated separately. Statistical analysis was performed using SPSS software, p <0.05 value was considered significant. Inventions Our patients received the standard EuroSCORE risk scoring system based on risk scores were divided into three risk groups. Low-risk group, 113 (52.3%), intermediate-risk group, 64 (29.6%) and high-risk group, 39 (18.1%) had patients. A total of 12 patients (5.6%), remained with mortality within the first 30 days. There was no mortality in low-risk group. Intermediate-risk group, 6 patients (7.1%) and high-risk group, 6 patients (15.4%) died. 3 patients were woman and 9 patients were male of these 12 patients with mortal. In the analysis of the area under the ROC curve (AUC), It was found to be EuroSCORE was 0.816, and Log.EuroSCORE was 0.791.When the areas under the curve were compared, it was not found significant difference in a statistically between mortality forecasting performances of two scores. When actual mortality and the standard EuroSCORE expected mortality were compered, we saw incompatible results in middle and high-risk group; We saw the expected mortality rate is lower than actual mortality. There was not mortal patient in The low-risk group; occurred mortality was 0% and expected mortality was 1,55 ± 1,04. In Intermediate-risk group, occurred mortality was 7%, 1 and expected mortality was 4,94 ± 0,77. Actual mortality in high-risk group was 15.4% and expected mortality was 8,62 ± 1,87. In total mortality was 5,6% and expected mortality was 4,14 ± 2,84. 213 of 216 patients surveyed (94%) preoperative renal function was normal. 13 patients (6%) had preoperative renal dysfunction. In 6 patients (66.7%) of total 9 patient, who were mortal developed kidney damage, 3 patients (33.3%) was not observed renal dysfunction. After operation period, renal dysfunction was observed in 82 patients (38.0%). It was not observed the statistical difference between the type of operation with the renal dysfunction (p> 0.05). Results Because most of the systems affected by open heart surgery, it is a high complication rate application. Analysis of risk factors that play a role in the development of these complications contribute to the reduction of mortality and morbidity.