Scoring Systems for Predicting Mortality After Valve Surgery

Primary Risk Stratification Systems

The Society of Thoracic Surgeons (STS) score is the recommended scoring system for predicting mortality after valve surgery in the Philippines due to its superior calibration and discrimination specifically for valve procedures 1, 2
The European System for Cardiac Operative Risk Evaluation (EuroSCORE II) is an alternative option that has been updated to improve its performance in predicting mortality after valve surgery 3

The STS risk calculator incorporates patient demographics, comorbidities, cardiac function parameters, and procedure-specific factors to generate a predicted risk of mortality 1, 2
Key variables in the STS score include age, gender, functional status, previous cardiac surgery, left ventricular ejection fraction, pulmonary hypertension, renal function, and emergency status 1, 4
For valve surgery specifically, the STS model accounts for the type of valve procedure (repair vs. replacement) and whether concomitant procedures such as CABG are planned 2, 5

For Filipino patients undergoing valve surgery, the STS risk calculator should be used to estimate operative risk and guide clinical decision-making 1, 3
Individual risks should be calculated using the online STS risk calculator prior to valve procedures as part of the shared decision-making process 1
Risk assessment should be performed by the multidisciplinary heart team, with the STS score serving as an objective measure to guide discussions about procedural benefits versus risks 1, 4

Patients with STS score <3% are considered low-risk for surgical aortic valve replacement 1
Patients with STS score >8% are considered high surgical risk and may benefit from consideration of alternative approaches 1
For mitral valve repair for primary mitral regurgitation, an STS score <1% indicates low risk 1