Chong Wang1,2, Lei Jin2, Fan Qiao2, Qing Xue2, Xin Guan Zhang2, Lin Han2. 1. Department of Cardiac Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China. 2. Department of Cardiothoracic Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
Abstract
BACKGROUND: To evaluate the performance of Society of Thoracic Surgeons (STS) 2008 cardiac surgery risk scores for postoperative complications in Chinese patients undergoing single valve surgery at multicenter institutions. METHODS: From January 2009 through December 2012, 4493 consecutive patients older than 16 years who underwent single valve surgery at 4 cardiac surgical centers were collected and scored according to the STS 2008 risk scores. The final research population included the following isolated heart valve surgery types: aortic valve replacement, mitral valve replacement, and mitral valve repair. Calibration of the risk scores was assessed by the Hosmer–Lemeshow (H-L) test. Discrimination was tested by calculating the area under the receiver operating characteristic (ROC) curve. RESULTS: The observed incidence rate for cerebrovascular accident (CVA), renal failure (RF), prolonged ventilation (Vent), reoperation (Reop), prolonged postoperative length of stay (PLOS), and short postoperative LOS (SLOS) was 0.90%, 1.32%, 4.18%, 2.43%, 3.64%, and 1.65%, respectively. The predicted incidence rate for CVA, RF, Vent, Reop, PLOS, and SLOS was 0.76%, 1.55%, 4.94%, 6.69%, 3.92%, and 2.54%, respectively. The STS 2008 risk scores give an accurate calibration for individual postoperative risk in CVA, RF, Vent, and PLOS (Hosmer–Lemeshow: P = .052, P = .474, P = .468, and P = .712, respectively). The area under the ROC curve of the STS 2008 risk scores for the above 4 postoperative complications were 0.714, 0.724, 0.727%, and 0.713, respectively. CONCLUSION: The STS 2008 risk scores were suitable for major postoperative complications in patients undergoing single valve surgery, except for Reop and SLOS.
BACKGROUND: To evaluate the performance of Society of Thoracic Surgeons (STS) 2008 cardiac surgery risk scores for postoperative complications in Chinese patients undergoing single valve surgery at multicenter institutions. METHODS: From January 2009 through December 2012, 4493 consecutive patients older than 16 years who underwent single valve surgery at 4 cardiac surgical centers were collected and scored according to the STS 2008 risk scores. The final research population included the following isolated heart valve surgery types: aortic valve replacement, mitral valve replacement, and mitral valve repair. Calibration of the risk scores was assessed by the Hosmer–Lemeshow (H-L) test. Discrimination was tested by calculating the area under the receiver operating characteristic (ROC) curve. RESULTS: The observed incidence rate for cerebrovascular accident (CVA), renal failure (RF), prolonged ventilation (Vent), reoperation (Reop), prolonged postoperative length of stay (PLOS), and short postoperative LOS (SLOS) was 0.90%, 1.32%, 4.18%, 2.43%, 3.64%, and 1.65%, respectively. The predicted incidence rate for CVA, RF, Vent, Reop, PLOS, and SLOS was 0.76%, 1.55%, 4.94%, 6.69%, 3.92%, and 2.54%, respectively. The STS 2008 risk scores give an accurate calibration for individual postoperative risk in CVA, RF, Vent, and PLOS (Hosmer–Lemeshow: P = .052, P = .474, P = .468, and P = .712, respectively). The area under the ROC curve of the STS 2008 risk scores for the above 4 postoperative complications were 0.714, 0.724, 0.727%, and 0.713, respectively. CONCLUSION: The STS 2008 risk scores were suitable for major postoperative complications in patients undergoing single valve surgery, except for Reop and SLOS.