{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T10:58:16Z","timestamp":1793271496566,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T00:00:00Z","timestamp":1622419200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>\u2002<\/jats:title>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>We sought to evaluate the predictive power of the Society of Thoracic Surgeons\u2013European Association for Cardio-Thoracic Surgery (STAT) mortality score and the adult congenital heart surgery (ACHS) mortality score for the adults undergoing congenital heart operations entered into the European Congenital Heart Surgeons Association (ECHSA) database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The data set comprised 17\u2009662 major operations performed between 1997 and 2019, on patients 18\u2009years of age or older, in European centres participating in the ECHSA database. Each operation was assigned a STAT mortality score and category and an ACHS mortality score. Operative mortality was based on the 30-day status and on the status at hospital discharge. The discriminatory power of the STAT and ACHS scores was assessed using the area under the receiver operating characteristic curve (c-index).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 17\u2009214 (97.46%) operations were assigned ACHS scores. The 3 most frequent primary procedures were closure of the atrial septal defect (19.0%), aortic valve replacement (8.8%) and non-valve-sparing aortic root replacement (6.1%). Operative mortality for ACHS-coded operations was 2.07%. The procedures with the highest mortality were atrial septal defect creation\/enlargement (19.0%), lung transplantation (18.8%) and heart transplantation (18.2%). A total of 17\u2009638 (99.86%) operations were assigned a STAT score and category. The operative mortality for STAT-coded operations was 2.27%. The c-index for mortality was 0.720 for the STAT mortality score and 0.701 for the ACHS score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The ACHS mortality score and the STAT mortality score reached similar, moderate predictive power in adult patients undergoing congenital heart surgery in ECHSA database.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezab229","type":"journal-article","created":{"date-parts":[[2021,4,26]],"date-time":"2021-04-26T15:20:27Z","timestamp":1619450427000},"page":"1397-1404","source":"Crossref","is-referenced-by-count":15,"title":["Risk evaluation in adult congenital heart surgery: analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database risk models on data from the European Congenital Heart Surgeons Association Congenital Database"],"prefix":"10.1093","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7947-8637","authenticated-orcid":false,"given":"Jelena","family":"Pabst von Ohain","sequence":"first","affiliation":[{"name":"Department of Congenital and Paediatric Heart Surgery, German Heart Centre Munich, Munich, Germany"},{"name":"Division of Congenital and Paediatric Heart Surgery, University Hospital of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9341-2850","authenticated-orcid":false,"given":"Georgios","family":"Sarris","sequence":"additional","affiliation":[{"name":"Department of Pediatric Heart Surgery, Athens Heart Surgery Institute, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zdzislaw","family":"Tobota","sequence":"additional","affiliation":[{"name":"Department for Pediatric Cardiothoracic Surgery, Paediatric Cardiothoracic Surgery, Children\u2019s Memorial Health Institute, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4144-6677","authenticated-orcid":false,"given":"Bohdan","family":"Maruszewski","sequence":"additional","affiliation":[{"name":"Department for Pediatric Cardiothoracic Surgery, Paediatric Cardiothoracic Surgery, Children\u2019s Memorial Health Institute, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1829-0259","authenticated-orcid":false,"given":"Vladimiro L","family":"Vida","sequence":"additional","affiliation":[{"name":"Paediatric and Cardiac Surgery Unit, Department of Cardio-Thoracic Vascular Sciences and Public Health, University of Padua, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"H\u00f6rer","sequence":"additional","affiliation":[{"name":"Department of Congenital and Paediatric Heart Surgery, German Heart Centre Munich, Munich, Germany"},{"name":"Division of Congenital and Paediatric Heart Surgery, University Hospital of Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,5,31]]},"reference":[{"key":"2021120506080812600_ezab229-B1","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1016\/j.jacc.2010.03.085","article-title":"Changing mortality in congenital heart disease","volume":"56","author":"Khairy","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"2021120506080812600_ezab229-B2","doi-asserted-by":"crossref","first-page":"2118","DOI":"10.1161\/CIRCULATIONAHA.115.017202","article-title":"Survival prospects and circumstances of death in contemporary adult congenital heart disease patients under follow-up at a large tertiary centre","volume":"132","author":"Diller","year":"2015","journal-title":"Circulation"},{"key":"2021120506080812600_ezab229-B3","doi-asserted-by":"crossref","first-page":"2264","DOI":"10.1161\/CIRCULATIONAHA.110.946343","article-title":"Temporal trends in survival to adulthood among patients born with congenital heart disease from 1970 to 1992 in Belgium","volume":"122","author":"Moons","year":"2010","journal-title":"Circulation"},{"key":"2021120506080812600_ezab229-B4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jacc.2005.02.083","article-title":"The adult with congenital heart disease: born to be bad?","volume":"46","author":"Warnes","year":"2005","journal-title":"J Am Coll Cardiol"},{"key":"2021120506080812600_ezab229-B5","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1161\/CIRCULATIONAHA.113.008396","article-title":"Lifetime prevalence of congenital heart disease in the general population from 2000 to 2010","volume":"130","author":"Marelli","year":"2014","journal-title":"Circulation"},{"key":"2021120506080812600_ezab229-B6","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.athoracsur.2006.07.045","article-title":"Risk of surgery for congenital heart disease in the adult: a multicentered European study","volume":"83","author":"Vida","year":"2007","journal-title":"Ann Thorac Surg"},{"key":"2021120506080812600_ezab229-B7","doi-asserted-by":"crossref","first-page":"754","DOI":"10.21037\/cdt.2018.10.06","article-title":"Current spectrum, challenges and new developments in the surgical care of adults with congenital heart disease","volume":"8","author":"Horer","year":"2018","journal-title":"Cardiovasc Diagn Ther"},{"key":"2021120506080812600_ezab229-B8","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1093\/eurheartj\/eht257","article-title":"Congenital heart disease beyond the age of 60: emergence of a new population with high resource utilization, high morbidity, and high mortality","volume":"35","author":"Tutarel","year":"2014","journal-title":"Eur Heart J"},{"key":"2021120506080812600_ezab229-B9","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1016\/j.athoracsur.2017.12.018","article-title":"Evaluation of the adult congenital heart surgery mortality score at two European centers","volume":"105","author":"H\u00f6rer","year":"2018","journal-title":"Ann Thorac Surg"},{"key":"2021120506080812600_ezab229-B10","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1136\/heartjnl-2016-310384","article-title":"Contemporary cardiac surgery for adults with congenital heart disease","volume":"103","author":"Beurtheret","year":"2017","journal-title":"Heart"},{"key":"2021120506080812600_ezab229-B11","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1177\/2150135116656001","article-title":"Mortality following congenital heart surgery in adults can be predicted accurately by combining expert-based and evidence-based pediatric risk scores","volume":"7","author":"Horer","year":"2016","journal-title":"World J Pediatr Congenit Heart Surg"},{"key":"2021120506080812600_ezab229-B12","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1016\/j.jtcvs.2009.03.071","article-title":"An empirically based tool for analyzing mortality associated with congenital heart surgery","volume":"138","author":"O'Brien","year":"2009","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2021120506080812600_ezab229-B13","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1093\/ejcts\/ezs026","article-title":"Initial application in the EACTS and STS Congenital Heart Surgery Databases of an empirically derived methodology of complexity adjustment to evaluate surgical case mix and results","volume":"42","author":"Jacobs","year":"2012","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021120506080812600_ezab229-B14","doi-asserted-by":"crossref","first-page":"1728","DOI":"10.1016\/j.athoracsur.2015.07.002","article-title":"Estimating mortality risk for adult congenital heart surgery: an analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database","volume":"100","author":"Fuller","year":"2015","journal-title":"Ann Thorac Surg"},{"key":"2021120506080812600_ezab229-B15","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.ejcts.2010.07.032","article-title":"Risk stratification for adult congenital heart surgery","volume":"39","author":"van Gameren","year":"2011","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021120506080812600_ezab229-B16","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1016\/j.jtcvs.2013.09.053","article-title":"Assessing surgical risk for adults with congenital heart disease: are pediatric scoring systems appropriate?","volume":"147","author":"Kogon","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2021120506080812600_ezab229-B17","year":"2020"},{"key":"2021120506080812600_ezab229-B18","year":"2016"},{"key":"2021120506080812600_ezab229-B19","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.1016\/j.athoracsur.2005.11.063","article-title":"What is operative mortality? Defining death in a surgical registry database: a report of the STS Congenital Database Taskforce and the Joint EACTS-STS Congenital Database Committee","volume":"81","author":"Jacobs","year":"2006","journal-title":"Ann Thorac Surg"},{"key":"2021120506080812600_ezab229-B20","doi-asserted-by":"crossref","first-page":"725","DOI":"10.21037\/cdt.2018.12.05","article-title":"Aortic dilatation in complex congenital heart disease","volume":"8","author":"Niwa","year":"2018","journal-title":"Cardiovasc Diagn Ther"},{"key":"2021120506080812600_ezab229-B21","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1177\/2150135113485763","article-title":"Patient age at the Ross operation in children influences aortic root dimensions and aortic regurgitation","volume":"4","author":"Horer","year":"2013","journal-title":"World J Pediatr Congenit Heart Surg"},{"key":"2021120506080812600_ezab229-B22","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/j.ejcts.2008.06.019","article-title":"Risk factors for aortic insufficiency and aortic valve replacement after the arterial switch operation","volume":"34","author":"Lange","year":"2008","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021120506080812600_ezab229-B23","year":"2019"},{"key":"2021120506080812600_ezab229-B24","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1093\/ejcts\/ezs043","article-title":"EuroSCORE II","volume":"41","author":"Nashef","year":"2012","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021120506080812600_ezab229-B25","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.ejcts.2009.01.046","article-title":"Seventeen years of adult congenital heart surgery: a single centre experience","volume":"36","author":"Putman","year":"2009","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021120506080812600_ezab229-B26","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1016\/j.athoracsur.2015.07.014","article-title":"The Society of Thoracic Surgeons Congenital Heart Surgery Database mortality risk model: part 1\u2014statistical methodology","volume":"100","author":"O\u2019Brien","year":"2015","journal-title":"Ann Thorac Surg"},{"key":"2021120506080812600_ezab229-B27","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1016\/j.athoracsur.2014.07.029","article-title":"The importance of patient-specific preoperative factors: an analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database","volume":"98","author":"Jacobs","year":"2014","journal-title":"Ann Thorac Surg"},{"key":"2021120506080812600_ezab229-B28","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1016\/j.ejcts.2004.03.027","article-title":"The Aristotle score: a complexity-adjusted method to evaluate surgical results","volume":"25","author":"Lacour-Gayet","year":"2004","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021120506080812600_ezab229-B29","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1136\/heartjnl-2017-312275","article-title":"Validation of the grown-ups with congenital heart disease score","volume":"104","author":"H\u00f6rer","year":"2018","journal-title":"Heart"},{"key":"2021120506080812600_ezab229-B30","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/j.athoracsur.2019.01.069","article-title":"Refining the Society of Thoracic Surgeons Congenital Heart Surgery Database mortality risk model with enhanced risk adjustment for chromosomal abnormalities, syndromes, and noncardiac congenital anatomic abnormalities","volume":"108","author":"Jacobs","year":"2019","journal-title":"Ann Thorac Surg"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/60\/6\/1397\/41431801\/ezab229.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/60\/6\/1397\/41431801\/ezab229.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,5]],"date-time":"2021-12-05T01:11:28Z","timestamp":1638666688000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/60\/6\/1397\/6289955"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,31]]},"references-count":30,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,5,31]]},"published-print":{"date-parts":[[2021,12,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezab229","relation":{},"ISSN":["1010-7940","1873-734X"],"issn-type":[{"value":"1010-7940","type":"print"},{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,12,1]]},"published":{"date-parts":[[2021,5,31]]}}}