| Sequential logistic models for 30 days mortality after CABG: pre-operative, intra-operative and post-operative experience--The Israeli CABG study (ISCAB). Three models for early mortality after CABG. | |
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MedLine Citation:
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PMID: 11049098 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The goal of this paper was to examine the added effect of operative and post-operative variables on 30 days mortality, in addition to patients' case-mix factors. SETTING AND DESIGN: A prospective study of 4835 patients, 95% of all Israeli patients who underwent coronary artery bypass grafting (CABG) in 1994. Information related to risk of death was collected at admission to hospital (preceding the operation), at time of the operation and in the immediate post-operative period. Deaths were independently ascertained. METHOD: Data collectors followed every patient from admission to discharge. Sequential logistic models were constructed for the 'case-mix', 'operative' and the 'post-operative' periods in chronological order. Each model incorporated and adjusted for the risk estimated at the previous point in time, by forcing individual risk scores. RESULTS: Significant pre-operative risk factors for 30 days mortality, in the case-mix model included mainly severity of illness characteristics, such as, left ventricular dysfunction and emergency admission, (c-statistic 78.8%). Model 2 (the 'operation' model) included in addition to the case-mix score, excessive duration of the operation per graft, bleeding, etc. (c-statistic 85.3%). The post-operative model showed the added effect of the post-operative factors such as low haemoglobin, additional surgery, and excessive time on respirator, (c-statistic 92.4%). CONCLUSIONS: The sequential analysis was an efficient method for updating patients' risk over time, where the number of events was small, relative to the number of risk factors. The addition of peri-operative factors increased significantly the predictive power of the model, adding clinical insights to the role of the hospital experience on 30 days mortality. |
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Authors:
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E Simchen; N Galai; Y Zitser-Gurevich; D Braun; B Mozes; S Elisheva; G Noya; Z G Yana; D Braun; M Benjamin |
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Publication Detail:
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Type: Journal Article; Multicenter Study |
Journal Detail:
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Title: European journal of epidemiology Volume: 16 ISSN: 0393-2990 ISO Abbreviation: Eur. J. Epidemiol. Publication Date: 2000 Jun |
Date Detail:
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Created Date: 2001-01-19 Completed Date: 2001-01-25 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8508062 Medline TA: Eur J Epidemiol Country: NETHERLANDS |
Other Details:
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Languages: eng Pagination: 543-55 Citation Subset: IM |
Affiliation:
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School of Public Health, Hebrew University and Hadassah, Jerusalem, Israel. esimchen@vms.huji.ac.il |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Distribution Aged Coronary Artery Bypass / mortality* Coronary Disease / surgery Female Humans Intraoperative Complications / mortality* Israel / epidemiology Logistic Models Male Middle Aged Odds Ratio Postoperative Complications / mortality* Preoperative Care / statistics & numerical data* Prospective Studies Risk Factors |
| Comments/Corrections | |
Erratum In:
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Eur J Epidemiol 2000;16(9):879 Note: Elisheva, S [corrected to Simchen, E]; Noya, G [corrected to Galai, N]; Yana, ZG [corrected to Zitser-Gurevich, Y]; Dalit, B [corrected to Braun, D]; Benjamin, M [corrected to Mozes, B] |
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