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12 REVISTA ARGENTINA DE CARDIOLOGÍA / VOL 83 SUPLEMENTO 2 / JUNIO 2015
revascularización miocárdica), observándose un muy
buen rendimiento del modelo local. (24)
También recientemente se ha desarrollado el
EuroSCORE II que, a diferencia del EuroSCORE I,
discrimina según el tipo de procedimiento a realizar,
pero se está observando que este nuevo modelo subestima
el riesgo predicho, tal como fue detectado en la
propia publicación del EuroSCORE II, (10) así como en
posteriores validaciones externas del modelo. (25-27)
En conclusión, existen múltiples modelos de riesgo
preoperatorio, (6-8, 10-13) cada centro debería evaluarlos
y utilizar el índice que mejor rendimiento tenga en
su población. El desarrollo de modelos de riesgo locales
puede contribuir a mejorar la capacidad predictiva de
eventos en el posoperatorio. (21, 28)
Finalmente, siempre debe tenerse en cuenta
que los modelos de riesgo preoperatorios son solo
herramientas que complementan el criterio clínico
y nunca lo reemplazan, ya que dicho criterio es fundamental
en la toma de decisiones de una eventual
cirugía valvular.
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