Risk index for predicting in-hospital mortality for cardiac valve surgery

被引:106
作者
Hannan, Edward L.
Wu, Chuntao
Bennett, Edward V.
Carlson, Russell E.
Culliford, Alfred T.
Gold, Jeffrey P.
Higgins, Robert S. D.
Smith, Craig R.
Jones, Robert H.
机构
[1] SUNY Albany, Dept Hlth Policy Management & Behav, Rensselaer, NY 12144 USA
[2] St Peters Hosp, Albany, NY USA
[3] Mercy Hosp, Buffalo, NY USA
[4] NYU, Med Ctr, New York, NY 10016 USA
[5] Med Univ Ohio, Toledo, OH USA
[6] Rush Univ, Med Ctr, Chicago, IL 60612 USA
[7] Columbia Presbyterian Med Ctr, New York, NY 10032 USA
[8] Duke Univ, Med Ctr, Durham, NC 27706 USA
关键词
D O I
10.1016/j.athoracsur.2006.09.051
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Numerous studies have developed a "severity score" or "risk index" for short-term mortality associated with coronary artery bypass graft (CABG) surgery, but very few studies have developed risk indices derived from statistical models to predict outcomes for cardiac valve replacement patients. Methods. Data from New York's Cardiac Surgery Reporting System in 2001 to 2003 were used to develop statistical models that predict mortality for valve surgery and for valve/CABG surgery. These models were used to develop risk indices based on the type of valve surgery performed and several patient risk factors. The fit of each index was tested by examining the correspondence of expected and observed mortality rates for various risk score ranges using New York data between 1998 and 2000. Results. There were a total of 11 risk factors for valve patients without CABG surgery and 12 risk factors for patients with both valve and CABG surgery. Risk factors represented measures of demographics, type of valve surgery, previous open heart surgery, ventricular function, hemodynamic state, and various comorbidities. Possible variable scores ranged from 0 to 7 in the isolated valve model and 0 to 5 in the valve/CABG model. The highest overall risk scores possible for the two models were 49 for isolated valve surgery and 35 for valve/CABG surgery, and the highest scores observed for any patient were 32 and 26, respectively. Conclusions. These valve surgery risk indices will enable providers to estimate patients' short-term mortality risk and allow for comparisons of valve surgery outcomes with other regions.
引用
收藏
页码:921 / 930
页数:10
相关论文
共 24 条
[1]   Generic, simple risk stratification model for heart valve surgery [J].
Ambler, G ;
Omar, RZ ;
Royston, P ;
Kinsman, R ;
Keogh, BE ;
Taylor, KM .
CIRCULATION, 2005, 112 (02) :224-231
[2]  
[Anonymous], 1989, Applied Logistic Regression
[3]   Prediction of operative mortality after valve replacement surgery [J].
Edwards, FH ;
Peterson, ED ;
Coombs, LP ;
DeLong, ER ;
Jamieson, WRE ;
Shroyer, ALW ;
Grover, FL .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2001, 37 (03) :885-892
[4]   Current determinants of operative mortality in 1400 patients requiring aortic valve replacement [J].
Florath, I ;
Rosendahl, UP ;
Mortasawi, A ;
Bauer, SF ;
Dalladaku, F ;
Ennker, IC ;
Ennker, JC .
ANNALS OF THORACIC SURGERY, 2003, 76 (01) :75-83
[5]   Comparison of short-term mortality risk factors for valve replacement versus coronary artery bypass graft surgery [J].
Gardner, SC ;
Grunwald, GK ;
Rumsfeld, JS ;
Cleveland, JC ;
Schooley, LM ;
Gao, DX ;
Grover, FL ;
McDonald, GO ;
Shroyer, AL .
ANNALS OF THORACIC SURGERY, 2004, 77 (02) :549-556
[6]   Risk stratification in heart surgery:: comparison of six score systems [J].
Geissler, HJ ;
Hölzl, P ;
Marohl, S ;
Kuhn-Régnier, F ;
Mehlhorn, U ;
Südkamp, M ;
de Vivie, ER .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2000, 17 (04) :400-405
[7]   EuroSCORE: a systematic review of international performance [J].
Gogbashian, A ;
Sedrakyan, A ;
Treasure, T .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2004, 25 (05) :695-700
[8]   THE MEANING AND USE OF THE AREA UNDER A RECEIVER OPERATING CHARACTERISTIC (ROC) CURVE [J].
HANLEY, JA ;
MCNEIL, BJ .
RADIOLOGY, 1982, 143 (01) :29-36
[9]   Risk stratification of in-hospital mortality for coronary artery bypass graft surgery [J].
Hannan, EL ;
Wu, CT ;
Bennett, EV ;
Carlson, RE ;
Culliford, AT ;
Gold, JP ;
Higgins, RSD ;
Isom, OW ;
Smith, CR ;
Jones, RH .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2006, 47 (03) :661-668
[10]   Predictors of mortality for patients undergoing cardiac valve replacements in New York State [J].
Hannan, EL ;
Racz, MJ ;
Jones, RH ;
Gold, JP ;
Ryan, TJ ;
Hafner, JP ;
Isom, OW .
ANNALS OF THORACIC SURGERY, 2000, 70 (04) :1212-1218