Performance of the EuroSCORE II and the STS score for cardiac surgery in octogenarians

Background: We aimed to investigate the predictive value of Society of Thoracic Surgeons (STS) and European System for Cardiac Operative Risk Evaluation (EuroSCORE II) scores for mortality in octogenarian cardiac surgery patients. Methods: Between January 2016 and December 2019, cardiac operations performed in 116 octogenarian patients (73 males, 43 females; mean age: 82.9 +/- 3.1 years; range, 80 to 97 years) were retrospectively analyzed. The patients with and without mortality were compared for their demographic and operative factors. The STS and EuroSCORE II scores, and observed mortality rates were assessed. Results: Mean STS score was 3.7 +/- 11.1 and mean EuroSCORE II was 5.2 +/- 5.4. For any operation type, the mean EuroSCORE II was significantly higher (8.1 +/- 7.4 vs. 4.1 +/- 4.0, respectively; p=0.006) in the patients with mortality. For elective operations, the mean EuroSCORE II was higher in cases with mortality (7.2 +/- 7.3 vs. 3.7 +/- 3.9, respectively; p=0.006); however, for urgent cases, there was no significant difference between the scores. Using the receiver operating characteristic curve, the EuroSCORE II had a higher area under the curve for all cases and elective cases than the STS scores. Conclusion: The EuroSCORE II performed better than the STS score for mortality prediction in octogenarians, whereas the predictions of either scoring system was unsatisfactory for urgent surgery and combined procedures. Population-based validation studies are needed for a better risk scoring system in this age group.