This study aimed to determine whether the preoperative risk stratification model EuroSCORE predicts the different components of resource utilization in open heart surgery.

Data for all adult patients undergoing heart surgery at the University Hospital of Lund, Sweden, between 1999 and 2002 were prospectively collected. Costs were calculated for the surgery and intensive care and ward stay for each patient (excluding transplant cases and patients who died intraoperatively). Regression analysis was applied to evaluate the correlation between EuroSCORE and costs. The predictive accuracy for prolonged postoperative intensive care unit (ICU) stay was assessed by the Hosmer-Lemeshow goodness-of-fit test. The discriminatory power was evaluated by calculating the areas under receiver operating characteristics curves.

The study included 3,404 patients. The mean cost for the surgery was 7,300,intheICU 3,746, and in the ward 3,500.TotalcostwassignificantlycorrelatedwithEuroSCORE,withacorrelationcoefficientof0.47(p<0.0001);thecorrelationcoefficientwas0.31forthesurgerycost,0.46fortheICUcost,and0.11forthewardcost.TheHosmer-LemeshowpvalueforEuroSCOREpredictionofmorethan2days'stayintheICUwas0.40,indicatinggoodaccuracy.Theareaunderthereceiveroperatingcharacteristicscurvewas0.78.TheprobabilityofanICUstayexceeding2dayswasmorethan50%ataEuroSCOREof14ormore.

Inthissingle-institutionstudy,theadditiveEuroSCOREalgorithmcouldbeusedtopredictICUcostandalsoanICUstayofmorethan2daysafteropenheartsurgery.