Validation of the Euroscore on Cardiac Surgery Patients in Nairobi
Background: The Additive Euroscore (AE) predicts outcomes in cardiac surgical procedures performed on cardiopulmonary bypass. It’s been widely used in developed nations but it’s applicability in Kenya is unknown. Our objective was to determine its applicability at Kenyatta National Hospital (Kenya). Methods: A retrospective study was carried out between 1st January 2011 and 31st December 2015. Risk factor prevalence was compared with that of the AE derivation population. The AE was calculated; discrimination was determined by receiver operator curve analysis. Results: Of 109 patients, significant differences (Kenyan vs. AE derivation) were found in the prevalence of pulmonary y hypertension (58.7% vs. 2%) and isolated coronary artery bypass graft surgery (4.6% vs. 65%). Only double valve replacement was a risk factor for operative mortality; odds ratio 5.98 (1.83to 19.49). The area under curve (AUC) for the AE was 0.59. Conclusion: The AUC for the AE implies poor discrimination in our population. Significant differences in the risk factor profile between our study population and the AE score derivation population may have contributed to this. Our findings suggest that the AE may not be applicable to patients in Kenya. We recommend that a local risk scoring system be developed.
Key words: Euroscore, Validation, Kenya