Preoperative prediction of early mortality in redocoronary artery surgery
| Autor: | Luc Noyez, Frans M. van Eck, Rene M.H.J. Brouwer, Freek W.A. Verheugt |
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| Rok vydání: | 2002 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Lung Diseases Male Reoperation medicine.medical_specialty Multivariate analysis Myocardial Infarction Preoperative care Sensitivity and Specificity Text mining Risk Factors Diabetes mellitus medicine Diabetes Mellitus Humans Myocardial infarction Derivation Coronary Artery Bypass Aged Probability Aged 80 and over Analysis of Variance Heartfunction and circulation Models Statistical Receiver operating characteristic business.industry Univariate General Medicine Middle Aged medicine.disease Prognosis Surgery Logistic Models Hartfunctie en circulatie Multivariate Analysis Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Journal of Cardio-Thoracic Surgery, 21, 6, pp. 1031-6 European Journal of Cardio-Thoracic Surgery, 21, 1031-6 |
| ISSN: | 1010-7940 |
| Popis: | Objectives: Construct a predictive model for early mortality in coronary reoperations (RECABG). Methods: Five hundred and forty one RECABG (1987–1998) were studied by univariate and multivariate analysis. Stepwise selective procedure ðp , 0:05Þ was used to identify a subset of variables with prognostic value for early mortality. This subset was used to calculate a prognostic score ‘S’ and a predicted probability ‘P’ for early mortality, P ¼ 1=1 1 e 2S . Sensitivity analysis was used for evaluation. Results: The best predictive variables for early mortality were diabetes, vascular-, lung-disease, a myocardial infarction between the primary and the RECABG, acute- and emergency operation and the operative period. The prognostic accuracy (receiver operating characteristics curve (ROC) area) was 80%. Observed probabilities compare well with the predicted probabilities, and patients were classified in low risk (5%), intermediate risk (15%), high risk (30%) and very high risk (40%). A predicted probability of $0.40 was used as cut-off point for the prognostic test. The specificity of this test was 97%, sensitivity 33%, predictive value of a positive test 63% and 90% for a negative test. Conclusions: The results show that individual patients presented for RECABG, can be stratified according to their early mortality risk. This information can be used to inform the patient, and also to discus the opportunity of the RECABG. q 2002 Elsevier Science B.V. All rights reserved. |
| Databáze: | OpenAIRE |
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