EuroSCORE: Useful in Directing Preoperative Intra-Aortic Balloon Pump Placement in Cardiac Surgery?

Authors

  • David G. Healy
  • Devendran Veerasingam
  • Alfred E. Wood

DOI:

https://doi.org/10.1532/HSF98.20061037

Abstract

Background. The placement of preoperative intra-aortic balloon pumps (IABP) in high-risk patients has been described, although controversy remains regarding the appropriate selection of these patients. The EuroSCORE is a proven predictor of operative mortality for coronary artery bypass surgery (CABG). Our objective was to assess whether patients with a preoperative IABP had a 30-day mortality consistent with their predicted mortality.

Methods. Sixty-sis patients who had had an IABP sited while undergoing CABG were retrospectively identified. The additive EuroSCORE was calculated with omission of the IABP preoperative placement score of 3 points. Patients with a EuroSCORE <5 were considered low risk, and those ?m5 as high risk.

Results. High-risk patients with preoperative IABP placement had a significantly lower mortality (1/16, 6.25%) than predicted. The predicted versus actual mortality was 12.6% versus 6.25%.

Conclusion. Correct identification of appropriate patients who would benefit from pre-emptive placement of IABP could potentially be performed using the EuroSCORE.

References

Baskett R, O'Connor G, Hirsch G, et al. 2003. A main center comparison of intraaortic balloon pump utilization in isolated coronary artery bypass graft surgery. Ann Thorac Surg 76:1988-92.nBriguori C, Sarais C, Pagnotta P, et al. 2003. Elective versus provisional intra-aortic balloon pumping in high-risk percutaneous transluminal coronary angioplasty. Am Heart J 145:700-7.nBrodie B, Stuckey T, Hansen C, et al. 1999. Infra-aortic balloon counter-pulsation before primary percutaneous transluminal coronary angioplasty reduces catheterization laboratory events in high-risk patients with acute myocardial infarction. Am J Cardiol 84:18-23.nChristenson J, Simonet F, Badel P, et al. 1997. Evaluation of preoperative intra-aortic balloon pump support in high risk coronary patients. Eur J Cardiothorac Surg 11:1097-103.nChristenson J, Simonet F, Badel P, et al. 1999. Optimal timing of preoperative intraaortic balloon pump support in high-risk coronary patients. Ann Thorac Surg 68:934-9.nCraver J, Murrah C. 2001. Elective intraaortic balloon counter pulsation for high-risk off-pump coronary artery bypass operations. Ann Thorac Surg 71:1220-3.nKang N, Edwards M, Larbalestier R. 2001. Preoperative intraaortic balloon pumps in high risk patients undergoing open heart surgery. Ann Thorac Surg 72:54-7.nKim K, Lim C, Ahn H, et al. 2001. Intraaortic balloon pump therapy facilitates posterior vessel off-pump coronary artery bypass grafting in high-risk patients. Ann Thorac Surg 71:1964-8.nMarra C, De Santo L, Amarelli C, et al. 2002. Coronary artery bypass grafting in patients with severe left ventricular dysfunction: a prospective randomized study on the timing of perioperative intraaortic balloon pump support. Int J Artif Organs 25:141-6.nNashaf S, Roques F, Michel P, et al. 1999. European system for cardiac operative risk evaluation (EuroSCORE). Eur J Cardiothorac Surg 16:9-13.nNilsson J, Algotsson L, Hoglund P, et al. 2004. EuroSCORE predicts intensive care unit stay and costs of open heart surgery. Ann Thorac Surg 78:1528-35.nRoques F, Michel P, Goldstone A, et al. 2003. The logistic EuroSCORE. Eur Heart J 24:881-2.nSuzuki T, Okabe M, Handa M, et al. 2004. Usefulness of preoperative intraaortic balloon pump therapy during off-pump coronary artery bypass grafting in high-risk patients. Ann Thorac Surg 77:2056-60.n

Published

2006-11-08

How to Cite

Healy, D. G., Veerasingam, D., & Wood, A. E. (2006). EuroSCORE: Useful in Directing Preoperative Intra-Aortic Balloon Pump Placement in Cardiac Surgery?. The Heart Surgery Forum, 9(6), E893-E896. https://doi.org/10.1532/HSF98.20061037

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Section

Articles