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Category Medicine Tests

Age (Years): Gender: Renal Impairment: Extracardiac Arteriopathy: Poor Mobility: Previous Cardiac Surgery: Chronic Lung Disease: Active Endocarditis: Critical Preop State: Diabetes on Insulin: NYHA Class: CCS Class 4 Angina: LV Function: Recent MI (<90 days): Pulmonary Hypertension: Urgency: Weight of Intervention: Surgery on Thoracic Aorta:

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About

In the high-stakes environment of cardiac surgery, accurate risk stratification is not just a statistical exercise—it is a cornerstone of clinical decision-making and patient consent. The EuroSCORE II (European System for Cardiac Operative Risk Evaluation) is the updated gold standard model designed to predict in-hospital mortality.

This tool is essential for cardiac surgeons, cardiologists, and anesthetists who need to objectively assess a patient's preoperative profile. By factoring in 18 distinct clinical variables—ranging from renal function to the urgency of the procedure—this calculator provides a percentage-based probability of mortality. This data assists in determining the viability of surgical intervention, benchmarking quality of care, and managing patient expectations with transparency and precision.

Formulas

The EuroSCORE II is calculated using a logistic regression equation. The probability of mortality is derived from the linear combination of coefficients and patient variables.

Risk = e^L1 + e^L

Where L is the linear predictor calculated as:

L = k + c_age + c_gender + c_renal + ... + c_proc

Where k is the constant (-5.324537) and c represents the coefficient for each specific risk factor present.

Reference Data

Risk Factor Category	Variable	Logistic Coefficient (β)	Clinical Definition
Patient Factors	Age (per 5 years over 60)	0.02852	Continuous risk increase for every year over 60.
Renal Dysfunction	Creatinine >200 μmol/L	0.85922	Severe renal impairment significantly increases post-op complications.
Cardiac State	NYHA Class IV	0.55602	Patient has cardiac symptoms at rest.
Cardiac State	LVEF < 20% (Poor)	0.93632	Severely reduced Left Ventricular Ejection Fraction.
Procedure	Emergency	0.70391	Operation required before the beginning of the next working day.
Procedure	Weight of Intervention (Double)	0.00621	e.g., CABG + Valve repair.
Procedure	Surgery on Thoracic Aorta	0.65272	Involves repair or replacement of the thoracic aorta.
Patient Factors	Diabetes on Insulin	0.35427	Insulin-dependent diabetes mellitus (IDDM).

Frequently Asked Questions

The original additive EuroSCORE often overestimated risk in high-risk patients and was based on older surgical data. EuroSCORE II uses a logistic regression model calibrated on more recent patient data, providing a more accurate prediction of modern surgical outcomes.

Renal impairment is categorized by serum creatinine levels. 'Moderate' is 50-85 ml/min, 'Severe' is <50 ml/min, and 'Dialysis' indicates the patient is currently on dialysis, which carries the highest risk coefficient in this category.

This is defined as patients requiring ventricular tachycardia/fibrillation or aborted sudden death, preoperative cardiac massage, preoperative ventilation before arrival in the anesthetic room, preoperative inotropes or IABP, or acute renal failure (anuria or oliguria <10ml/hr).

No. EuroSCORE II is specifically validated for adult cardiac surgery. Pediatric risk stratification requires different models such as the RACHS-1 or Aristotle Score due to congenital complexities.