Document Detail


Risk score for predicting long-term mortality after coronary artery bypass graft surgery.
MedLine Citation:
PMID:  22547673     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: No simplified bedside risk scores have been created to predict long-term mortality after coronary artery bypass graft surgery.
METHODS AND RESULTS: The New York State Cardiac Surgery Reporting System was used to identify 8597 patients who underwent isolated coronary artery bypass graft surgery in July through December 2000. The National Death Index was used to ascertain patients' vital statuses through December 31, 2007. A Cox proportional hazards model was fit to predict death after CABG surgery using preprocedural risk factors. Then, points were assigned to significant predictors of death on the basis of the values of their regression coefficients. For each possible point total, the predicted risks of death at years 1, 3, 5, and 7 were calculated. It was found that the 7-year mortality rate was 24.2 in the study population. Significant predictors of death included age, body mass index, ejection fraction, unstable hemodynamic state or shock, left main coronary artery disease, cerebrovascular disease, peripheral arterial disease, congestive heart failure, malignant ventricular arrhythmia, chronic obstructive pulmonary disease, diabetes mellitus, renal failure, and history of open heart surgery. The points assigned to these risk factors ranged from 1 to 7; possible point totals for each patient ranged from 0 to 28. The observed and predicted risks of death at years 1, 3, 5, and 7 across patient groups stratified by point totals were highly correlated.
CONCLUSION: The simplified risk score accurately predicted the risk of mortality after coronary artery bypass graft surgery and can be used for informed consent and as an aid in determining treatment choice.
Authors:
Chuntao Wu; Fabian T Camacho; Andrew S Wechsler; Stephen Lahey; Alfred T Culliford; Desmond Jordan; Jeffrey P Gold; Robert S D Higgins; Craig R Smith; Edward L Hannan
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-04-30
Journal Detail:
Title:  Circulation     Volume:  125     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-22     Completed Date:  2012-07-24     Revised Date:  2013-06-25    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2423-30     Citation Subset:  AIM; IM    
Affiliation:
Department of Public Health Sciences, Penn State Hershey College of Medicine, Academic Support Bldg, Ste 2200, A210, 600 Centerview Dr, ASB 2200, Hershey, PA 17033, USA. chuntao.wu@psu.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Coronary Artery Bypass / mortality*
Coronary Disease / mortality*,  surgery*
Databases, Factual / statistics & numerical data
Female
Follow-Up Studies
Humans
Male
Middle Aged
Predictive Value of Tests
Proportional Hazards Models
Risk Assessment / methods
Risk Factors
Grant Support
ID/Acronym/Agency:
RC1 HL099122/HL/NHLBI NIH HHS; RC1HL099122/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
Circulation. 2012 May 22;125(20):2409-11   [PMID:  22547672 ]

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