Bayesian-logit model for risk assessment in coronary artery bypass grafting.

Predictive models for the assessment of operative risk using patient risk factors have gained popularity in the medical community as an important tool for the adjustment of surgical outcome. The Bayes' theorem model is among the various models used to predict mortality among patients undergoing coronary artery bypass grafting procedures. Comparative studies of the various classic statistical techniques, such as logistic regression, cluster of variables followed by a logistic regression, a subjectively created sickness score, classification trees model, and the Bayes' theorem model, have shown that the Bayes' model is among those with the highest predictive power. In this study, the Bayes' theorem model is reformulated as a logistic equation and extended to include qualitative and quantitative risk factors. We show that the resulting model, the Bayesian-logit model, is a mixture of logistic regression and linear discriminant analysis. This new model can be created easily without complex computer programs. Using 12,712 patients undergoing coronary artery bypass grafting procedures at the Department of Veterans Affairs Continuous Improvement in Cardiac Surgery Study between April 1987 and March 1990, the predictive power of the Bayesian-logit model is compared with the Bayes' theorem model, logistic regression, and discriminant analysis. The ability of the Bayesian-logit model to discriminate between operative deaths and operative survivors is comparable with that of logistic regression and discriminant analysis.