Background: Accurate preoperative risk stratification is essential in patients undergoing coronary artery bypass grafting (CABG). EuroSCORE II is a commonly used risk prediction model for estimating operative mortality in cardiac surgery.

Objective: To evaluate the accuracy of EuroSCORE II in predicting early postoperative mortality in patients undergoing isolated CABG.

Materials and Methods: This retrospective observational study included 73 patients who underwent isolated CABG at a tertiary care center over a six month period. Data were collected from Medical Records Department case sheets. EuroSCORE II was calculated using standard preoperative variables, and patients were categorized into low, moderate, and high-risk groups. Predicted mortality was compared with observed in-hospital mortality.

Results: The overall observed mortality was 8.2%. Mortality occurred predominantly in the high-risk EuroSCORE II group. A statistically significant association was observed between EuroSCORE II risk categories and postoperative mortality (p = 0.00001). No significant independent association was found between age or ejection fraction and mortality.

Conclusion: EuroSCORE II is a useful and reliable tool for risk stratification and prediction of early mortality in patients undergoing isolated CABG.

• EuroSCORE II; Coronary artery bypass grafting; Operative mortality; Risk stratification; Cardiac surgery.

Palani J, Saravanan T (2026) Euroscore II–Predictive Mortality Risk in Patients Undergoing CABG –Retrospective. J Cardiol Clin Res. 14(1): 1221.

Coronary artery bypass grafting remains a definitive surgical treatment for advanced coronary artery disease. Accurate estimation of operative risk is essential for patient counseling, perioperative planning, and outcome assessment. EuroSCORE II was developed as an updated risk prediction model to improve mortality estimation in contemporary cardiac surgical practice. This study aims to assess the predictive accuracy of EuroSCORE II in patients undergoing isolated CABG in an Indian tertiary care setting.

This retrospective observational study was conducted in the Department of Cardiothoracic Surgery, Sree Balaji Medical College and Hospital, Chennai. All patients who underwent isolated CABG over a six-month period were included. Patients undergoing combined cardiac procedures were excluded. Data were collected from Medical Records Department case sheets. EuroSCORE II was calculated using the standard online calculator. The primary outcome was early postoperative (in-hospital) mortality. Data were entered and analyzed using Microsoft Excel. Categorical variables were expressed as frequencies and percentages. The association between EuroSCORE II risk categories and mortality was assessed using the Chi-square test, with p < 0.05 considered statistically significant.

Among the 73 patients included, the majority were classified into the low-risk EuroSCORE II category. Six deaths were observed, with most occurring in the high risk group. Predicted mortality increased across risk categories, and a statistically significant association was found between EuroSCORE II risk classification and observed mortality (p = 0.00001) (Table 1).

Table 1: Statistically significant association was found between EuroSCORE II risk classification and observed mortality (p = 0.00001).

Category Wise Distribution of Euroscore II

These findings indicate that EuroSCORE II effectively discriminates between different risk groups in CABG patients. Minor differences between predicted and observed mortality are expected in single-center retrospective studies. Overall, the results support the clinical usefulness of EuroSCORE II as a risk stratification tool rather than an exact predictor of individual outcomes (Figure 1).

Figure 1 These findings indicate that EuroSCORE II effectively discriminates between different risk groups in CABG patients

Association between Age and Mortality

Patients were grouped into <50 years, 50–60 years, and >60 years categories. Mortality was higher among patients aged >60 years, with three deaths reported, while no deaths were observed in patients below 50 years. However, statistical analysis revealed no significant association between age group and mortality (p = 0.59), suggesting that age alone did not independently influence early mortality in this cohort (Table 2 and Figure 2).

Table 2: Age of the patients and Mortality are Associated.

Figure 2 Bar chart representing association between Age and Mortality.

Association between Ejection Fraction and Mortality

Mortality was predominantly observed in patients with moderate ventricular dysfunction (EF 31–50%), where six deaths occurred. No deaths were reported in patients with good EF (>50%) or severely reduced EF (≤30%). The association between EF categories and mortality did not reach statistical significance (p = 0.06), although a trend toward increased mortality with declining EF was observed (Table 3 and Figure 3).

Figure 3 Bar chart representing association between Ejection Fraction and Mortality.

Table 3: Ejection fraction of the patients and Mortality are Associated.

EuroSCORE II is an effective and practical model for predicting early postoperative mortality in patients undergoing isolated coronary artery bypass grafting and can aid in preoperative risk assessment and clinical decision-making.

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