Cor Vasa 2025, 67(3):344-349 | DOI: 10.33678/cor.2025.005

Comparison of EuroSCORE II, STS Score, and ACEF II Score as Predictors of Mortality in CABG Patients at Tertiary Referral Hospital in East Indonesia

Yan Efrata Sembiring^a, Ali Mustofa^b, Andrianto^c, Heroe Soebroto^a

^a Department of Thoracic Cardiac and Vascular Surgery, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

^b Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

³ Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Background: Identifying the optimal surgical approach and therapy for a patient is an important step in the preoperative preparation process. Risk stratification models such as EuroSCORE II, STS score, and ACEF II score were created to assist in evaluating factors associated with surgical outcomes. This scoring models are now utilized to risk stratify patients having coronary artery bypass graft (CABG) surgery. However, it has not been determined which model is better for Indonesian patients. The purpose of this study was to compare EuroSCORE II, STS score, and ACEF II score in CABG patients from Indonesia.

Methods: A cross-sectional study was conducted from January 2021 to March 2023 by utilizing secondary data collected from medical records of all patients undergoing CABG. Receiver operating characteristic (ROC) curves were created, and the area under the ROC curve (AUC) was calculated to measure the discriminative power of each score.

Results: A total of 131 patients were included in the study. The overall observed mortality on the entire group was 7 (5%). The EuroSCORE II-predicted mortality was 1.58 ± 2.08, the STS score-predicted mortality was 1.14 ± 1.58, and the ACEF II score-predicted mortality was 1.60 ± 0.97. The discriminative ability for operative mortality by area under the curve for EuroSCORE II, STS Score, and ACEF II score was 0.94 (95% CI 0.86-0.99; p <0.0001), 0.93 (95% CI 0.81-0.99; p <0.0001), and 0.76 (95% CI 0.55-0.97; p <0.05), respectively.

Conclusion: This result suggests that EuroSCORE II, STS score, and ACEF II score have satisfactory discriminatory power. However, all three risk stratification models have their own strengths and limitation in their application and should be used wisely.

Keywords: ACEF II score, CABG, EuroSCORE II, Risk Stratification Model, STS score

Received: February 25, 2024; Revised: January 5, 2025; Accepted: January 5, 2025; Prepublished online: June 2, 2012; Published: June 20, 2025  Show citation