EUROSCORE II VALUE AS A PREDICTOR FOR MAJOR ADVERSE CARDIOVASCULAR EVENTS DURING ADMISSION IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS SURGERY IN HAJI ADAM MALIK GENERAL HOSPITAL MEDAN

Abstract

Background : Coronary heart disease is one of the causes of high rates of care and mortality in hospitals. Coronary artery bypass surgery (CABG) is one of the intervention therapy of coronary heart disease. EuroSCORE II is a scoring system that is often used in predicting mortality rates in patients undergoing cardiac surgery procedures, its role in predicting Major Adverse Cardiac Events (MACE) in cases of coronary artery bypass surgery is still very rare, especially in Indonesia.

Objective : To determine the relationship between EuroSCORE II value as a predictor of major adverse cardiac events during admission in patients undergoing coronary artery bypass surgery.

Methods : This study is a retrospective of 75 CHD patients who underwent CABG at H. Adam Malik General Hospital from June 2019 to June 2020. All subjects who will undergo CABG are counted for EuroSCORE II, then observed during hospitalization. The output that was monitored was MACE incidents during hospitalization. Statistical analysis was performed to assess the ability of EuroSCORE II to predict MACE during hospitalization.

Results : From 75 patients who underwent CABG, 12 patients (16%) had MACE and 63 other patients (84%) did not experience MACE. The MACE assessed were death, cardiogenic shock, acute heart failure, malignant arrhythmias, and stroke. Through the analysis of the ROC curve, it was found that the intercept value for EuroSCORE II was 3.31 (AUC 0.976, IK95% 0.944-1.00, p <0.001). Score ≥3.31 can predict MACE during treatment with a sensitivity of 91.7% and a specificity of 88.9%. The value of EuroSCORE II are low scores <2%, intermediate scores 2-5%, and high scores> 5% for MACE. There was a statistically significant relationship with EuroSCORE II value on each MACE which are mortality, malignant arrhythmias, cardiogenic shock, and acute heart failure with p value <0.05.

Conclusion : EuroSCORE II value can be used as a predictor of MACE during hospitalization in patients undergoing coronary artery bypass surgery.