Predictive Performance Analysis Of EuroSCORE ?? STS-SCORE And SinoSCORE In Early Mortality In Patients Undergoing AVR Or MVR

Objective:The aim of this study was to analyze and compare the efficiency of predicting the postoperative early mortality rate in aortic valve repalcement and mitral valve replacement through the three types of risk prediction models--SinoSCORE,EuroSCORE?,STS-SCORE,and evaluate their clinical application value in a further way.Method: A total of 1071 patients undergoing aortic valve repalcement and mitral valve replacement between January 2010 and January 2018 was retrospectively collected from our center was included in the study.Applying to three types risk prediction models--SinoSCORE,EuroSCORE?,STS-SCORE calculate the predictive mortality and compare with the actual mortality.Evaluation and prediction in calibration was performed by Hosmer-Lemeshow test;the evaluation in discrimination was performed by ROC(Receiver Operating Characteristic curve)and AUC(Area Under Curve).The evaluation of the prediction about group AVR,group MVR and all patients depends on the Calibration and Discimination.Compare and select the optimal model to guide clinical preoperative decision.Result: Eighteen of 1071 patients are died after operation;The actual mortality in all patients was 1.68%.The predictive mortality calculated by SinoSCORE,EuroSCORE?,STS-SCORE was 1.52%?1.39%?1.16%.The predicted result of SinoSORCE is the closest to the actual mortality.For total patients,three systems all showed good calibrations with P value of H-L higher than 0.05.SinoSCORE(AUC=0.744>0.70)showed high discriminatory ability in predicting mortality.Nine of 489 patients that having undergone aortic valve repalcement are died after operation;The actual mortality was 1.84%.The predictive mortality in the group AVR calculated by SinoSCORE,EuroSCORE?,STS-SCORE was 1.68%,1.36%,0.98%;SinoSCORE and EuroSCORE II showed good calibrations with P value of H-L higher than 0.05,while the STS-SCORE performed poor(p<0.05).SinoSCORE(AUC=0.712>0.70)showed good discriminatory ability in predicting mortality.Nine of 582 patients that having undergone mitral valve replacement are died after operation;The actual mortality was 1.55%.The predictive mortality for SinoSCORE?EuroSCORE??STS-SCORE was 1.39%,1.41%,1.32%;three systems all showed good calibrations with P value of H-L higher than 0.05.SinoSCORE and EuroSCORE(AUC=0.768 ? 748>0.70)showed good discriminatory ability in predicting mortality.Conclusion: SinoSCORE gives a remarkable prediction efficiency for mortality risk in patients undergoing aortic valve replacemen and mitral valve replacement.EuroSCORE reflects a better discrimination for mortality risk in patients undergoing mitral valve replacement.STS-SCORE gives an imprecise prediction efficiency for both mitral valve replacement and aortic valve replacement.