EuroSCORE II vs Precise DAPT

EuroSCORE stands for European System for Cardiac Operative Risk Evaluation. It identifies a number of risk factors which help to predict mortality from cardiac surgery. The original EuroSCORE calculator was published in 1999, derived from an international database of patients undergoing cardiac surgery. The EuroSCORE II calculator was released for use on October 3, 2011 at the European Association of Cardiothoracic Surgery meeting in Lisbon. The original calculator is used worldwide for both the measurement of risk and as a benchmark for the assessment of quality of cardiac surgical services. There are more than 1300 formal citations of the EuroSCORE in the medical literature. The previous additive and logistic EuroSCORE versions are now inappropriately calibrated but have remained powerfully discriminatory. Nevertheless, there is evidence that discrimination may be improved further by refining and modifying some of the risk factors, such as renal dysfunction. Therefore, the new EuroSCORE II calculator was developed to optimize its useful application in contemporary practice. The EuroSCORE II calculator is to be used as an educational tool only, and it should not be viewed as a substitute for the opinion of expert Cardiac Surgeons and Cardiologists. Clinical judgement must be used whenever rare risk factors are present. The risk model provides a set standard, and units and surgeons will perform at, above or below the standard. Best practice in quoting risk to patients is to adjust the risk calculated by EuroSCORE II to the results achieved by the unit in question. The application is meant to be used as a tool to guide discussions with patients, families, and healthcare providers regarding the potential outcomes after open heart surgery.

The PRECISE-DAPT score calculator provides the percentage probability of major bleeding at twelve months in patients with coronary artery disease treated with dual antiplatelet therapy after coronary stenting. This tool is designed to support clinicians decision making for dual antiplatelet therapy duration after coronary stenting. This calculator specifically designed for mobile devices, provides a rapid and intuitive assessment of patients' bleeding risk. Additional features include: – PRECISE-DAPT score calculation – Estimate of bleeding risk at 12-months for TIMI major and TIMI major or minor bleeding – Bleeding risk status according to the original score categories – Reporting system including all relevant information regarding the antiplatelet therapy selection and stenting procedure – An advanced e-mail reporting system to share information with the patient or other clinicians The PRECISE-DAPT score calculator includes 5 predictive risk factors to calculate the probability of major bleeding: Age Creatinin Clearance Haemoglobin levels White blood cell count History of previous spontaneous bleeding The score has been developed from a collaborative dataset including 14,963 patients from 8 randomized clinical trials, enrolled in more than 130 clinical sites and 12 countries worldwide. The PRECISE-DAPT Risk Score has been externally validated in two independent datasets. The PRECISE-DAPT Score and all related materials are for exclusive use of health care professionals and is intended as a supportive risk assessment tool which should never replace clinical judgment, physician–patient relationship or medical advice. Treatment risks and benefits should always be considered in the context of a comprehensive professional clinical assessment, taking into account all available data and treatment options. Physicians and other healthcare providers should always exercise their own clinical judgment for any given situation.