BACKGROUND: To establish a risk score for heart surgery allows the assessment of preoperative risk, informing the patient and defining care during the intervention. OBJECTIVE: To assess preoperative risk factors for death in cardiac valve surgery and construct a simple risk model (score) for in-hospital mortality of patients candidate to surgery at Hospital São Lucas of Pontifícia Universidade Católica do Rio Grande do Sul (HSL-PUCRS). METHODS: The study sample included 1,086 adult patients that underwent cardiac valve surgery between January 1996 and December 2007 at HSL-PUCRS. Logistic regression was used to identify risk and in-hospital mortality factors. The model was developed in 699 patients and its performance was tested in the remaining data (n = 387). The final model was created using the total study sample (n = 1,086). RESULTS: Global mortality was 11.8%: 8.8% of elective cases and 63.8% of emergency cases. At the multivariate analysis, 9 variables remained independent predictors for the outcome: advanced age, surgical priority, female sex, ejection fraction < 45%, concomitant myocardial revascularization (CABG), pulmonary hypertension, NYHA functional class III or IV, creatinine levels (1.5 to 2.49 mg/dl and > 2.5 mg/dl or undergoing dialysis). The area under the ROC curve was 0.83 (95% CI: 0.78-0.86). The risk model showed good capacity for observed/predicted mortality: the Hosmer-Lemeshow test was x(2) = 5.61; p = 0.691 and r = 0.98 (Pearson's coefficient). CONCLUSION: The variables predictive of in-hospital mortality allowed the construction of a simplified risk score for daily practice, which classifies the patient as having low, moderate, high, very high and extremely high preoperative risk.
BACKGROUND: To establish a risk score for heart surgery allows the assessment of preoperative risk, informing the patient and defining care during the intervention. OBJECTIVE: To assess preoperative risk factors for death in cardiac valve surgery and construct a simple risk model (score) for in-hospital mortality of patients candidate to surgery at Hospital São Lucas of Pontifícia Universidade Católica do Rio Grande do Sul (HSL-PUCRS). METHODS: The study sample included 1,086 adult patients that underwent cardiac valve surgery between January 1996 and December 2007 at HSL-PUCRS. Logistic regression was used to identify risk and in-hospital mortality factors. The model was developed in 699 patients and its performance was tested in the remaining data (n = 387). The final model was created using the total study sample (n = 1,086). RESULTS: Global mortality was 11.8%: 8.8% of elective cases and 63.8% of emergency cases. At the multivariate analysis, 9 variables remained independent predictors for the outcome: advanced age, surgical priority, female sex, ejection fraction < 45%, concomitant myocardial revascularization (CABG), pulmonary hypertension, NYHA functional class III or IV, creatinine levels (1.5 to 2.49 mg/dl and > 2.5 mg/dl or undergoing dialysis). The area under the ROC curve was 0.83 (95% CI: 0.78-0.86). The risk model showed good capacity for observed/predicted mortality: the Hosmer-Lemeshow test was x(2) = 5.61; p = 0.691 and r = 0.98 (Pearson's coefficient). CONCLUSION: The variables predictive of in-hospital mortality allowed the construction of a simplified risk score for daily practice, which classifies the patient as having low, moderate, high, very high and extremely high preoperative risk.
Authors: Dimas Tadahiro Ikeoka; Viviane Aparecida Fernandes; Otavio Gebara; Jose Carlos Teixeira Garcia; Pedro Gabriel Melo de Barros e Silva; Marcelo Jamus Rodrigues; Valter Furlan; Antonio Claudio do Amaral Baruzzi Journal: Rev Bras Cir Cardiovasc Date: 2014 Jan-Mar
Authors: Handerson Nunes dos Santos; Ellen Hettwer Magedanz; João Carlos Vieira da Costa Guaragna; Natalia Nunes dos Santos; Luciano Cabral Albuquerque; Marco Antonio Goldani; João Batista Petracco; Luiz Carlos Bodanese Journal: Rev Bras Cir Cardiovasc Date: 2014 Apr-Jun
Authors: Omar A V Mejia; Manuel J Antunes; Maxim Goncharov; Luís R P Dallan; Elinthon Veronese; Gisele A Lapenna; Luiz A F Lisboa; Luís A O Dallan; Carlos M A Brandão; Jorge Zubelli; Flávio Tarasoutchi; Pablo M A Pomerantzeff; Fabio B Jatene Journal: PLoS One Date: 2018-07-06 Impact factor: 3.240
Authors: Leonardo Sinnott Silva; Paulo Ricardo Avancini Caramori; Antonio Carlos Bacelar Nunes Filho; Marcelo Katz; João Carlos Vieira da Costa Guaragna; Pedro Lemos; Valter Lima; Alexandre Abizaid; Flavio Tarasoutchi; Fabio S de Brito Journal: Arq Bras Cardiol Date: 2015-07-31 Impact factor: 2.000
Authors: Benjamin S Wessler; Christine M Lundquist; Benjamin Koethe; Jinny G Park; Kristen Brown; Tatum Williamson; Muhammad Ajlan; Zuhair Natto; Jennifer S Lutz; Jessica K Paulus; David M Kent Journal: J Am Heart Assoc Date: 2019-10-04 Impact factor: 5.501