Euro SCORE as a Predictor of Extended Intensive Care Unit Stay After Cardiac Surgery

Document Type : Original Article


Center for Cardiac Surgery, Clinical Center of Montenegro, Podgorica, Montenegro


Background: Risk stratification models allow preoperative assessment of individual patients cardiac surgical risk and enable analysis of postoperative outcome in the intensive care unit (ICU) as well. Objectives: The aim of this single-center study was to explore the prediction of extended ICU stay after cardiac surgery using the European System for Cardiac Operative Risk Evaluation (Euro SCORE). Patients and Methods: A retrospective cross-sectional study was conducted. We collected clinical data of 1841 consecutive patients undergoing cardiac surgery. The outcome measure was the duration of ICU stay in days. The predictive performance of Euro SCORE was analyzed by the discriminatory power of a receiver operating characteristic (ROC) curve. Results: Overall observed mortality was 3.5% (57/1841). Patients had a median ICU stay of 3 days and a mean ICU stay of 3.1 days. Mean additive Euro SCORE was 4.36% (range: 0-21) and logistic Euro SCORE was 4.81% (range: 0.88-44.28). The logistic Euro SCORE model yielded an area under the ROC curve of 0.832, 0.768 and 0.643 for each ICU length of stay, respectively (7, 5, 3 days). Values of Euro SCORE and ICU stay were positively correlated (P < 0.001). Conclusions: In our center, prolonged length of stay in the ICU correlated positively with Euro SCORE. The overall predictive performance of Euro SCORE is acceptable and provides both surgeons and intensivists with a good estimate of patient risk in terms of ICU stay.


  1. 1.Roques F, Nashef SA, Michel P, Gauducheau E, de Vincentiis C, Baudet E, et al. Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients. Eur J Cardiothorac Surg. 1999;15(6):816–22.

    1. Roques F. The logistic EuroSCORE. European Heart Journal. 2003;24(9):882.
    2. Clark RE. Calculating risk and outcome: The Society of Thoracic Surgeons database. Ann Thorac Surg. 1996;62(5 Suppl):S2–5.
    3. Parsonnet V. Risk stratification in cardiac surgery: is it worthwhile? J Card Surg. 1995;10(6):690–8. 5. Tu JV, Jaglal SB, Naylor CD. Multicenter validation of a risk index for mortality, intensive care unit stay, and overall hospital length of stay after cardiac surgery. Steering Committee of the Provincial Adult Cardiac Care Network of Ontario. Circulation. 1995;91(3):677–84.
    4. Shuhaiber JH, Goldsmith K, Nashef SA. The influence of seasonal variation on cardiac surgery: a time-related clinical outcome predictor. J Thorac Cardiovasc Surg. 2008;136(4):894–9.
    5. Nilsson J, Algotsson L, Hoglund P, Luhrs C, Brandt J. EuroSCORE predicts intensive care unit stay and costs of open heart surgery. Ann Thorac Surg. 2004;78(5):1528–34.