The importance of independent risk-factors for long-term mortality prediction after cardiac surgery

I. K. Toumpoulis, C. E. Anagnostopoulos, J. P. Ioannidis, S. K. Toumpoulis, T. Chamogeorgakis, D. G. Swistel, Joseph DeRose

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: The purpose of the present study was to determine independent predictors for long-term mortality after cardiac surgery. The European System for Cardiac Operative Risk Evaluation (EuroSCORE) was developed to score in-hospital mortality and recent studies have shown its ability to predict long-term mortality as well. We compared forecasts based on EuroSCORE with other models based on independent predictors. Methods: Medical records of patients with cardiac surgery who were discharged alive (n = 4852) were retrospectively reviewed. Their operative surgical risks were calculated according to EuroSCORE. Patients were randomly divided into two groups: training dataset (n = 3233) and validation dataset (n = 1619). Long-term survival data (mean follow-up 5.1 years) were obtained from the National Death Index. We compared four models: standard EuroSCORE (M1); logistic EuroSCORE (M2); M2 and other preoperative, intra-operative and post-operative selected variables (M3); and selected variables only (M4). M3 and M4 were determined with multivariable Cox regression analysis using the training dataset. Results: The estimated five-year survival rates of the quartiles in compared models in the validation dataset were: 94.5%, 87.8%, 77.1%, 64.9% for M1; 95.1%, 88.0%, 80.5%, 64.4% for M2; 93.4%, 89.4%, 80.8%, 64.1% for M3; and 95.8%, 90.9%, 81.0%, 59.9% for M4. In the four models, the odds of death in the highest-risk quartile was 8.4-, 8.5-, 9.4- and 15.6-fold higher, respectively, than the odds of death in the lowest-risk quartile (P < 0.0001 for all). Conclusions: EuroSCORE is a good predictor of long-term mortality after cardiac surgery. We developed and validated a model using selected preoperative, intra-operative and post-operative variables that has better discriminatory ability.

Original languageEnglish (US)
Pages (from-to)599-607
Number of pages9
JournalEuropean Journal of Clinical Investigation
Volume36
Issue number9
DOIs
StatePublished - Sep 2006
Externally publishedYes

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Surgery
Thoracic Surgery
Mortality
Hospital Mortality
Regression analysis
Medical Records
Logistics
Survival Rate
Regression Analysis
Survival
Datasets

Keywords

  • Cardiac surgery
  • EuroSCORE
  • Independent predictors
  • Long-term mortality

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Toumpoulis, I. K., Anagnostopoulos, C. E., Ioannidis, J. P., Toumpoulis, S. K., Chamogeorgakis, T., Swistel, D. G., & DeRose, J. (2006). The importance of independent risk-factors for long-term mortality prediction after cardiac surgery. European Journal of Clinical Investigation, 36(9), 599-607. https://doi.org/10.1111/j.1365-2362.2006.01703.x

The importance of independent risk-factors for long-term mortality prediction after cardiac surgery. / Toumpoulis, I. K.; Anagnostopoulos, C. E.; Ioannidis, J. P.; Toumpoulis, S. K.; Chamogeorgakis, T.; Swistel, D. G.; DeRose, Joseph.

In: European Journal of Clinical Investigation, Vol. 36, No. 9, 09.2006, p. 599-607.

Research output: Contribution to journalArticle

Toumpoulis, IK, Anagnostopoulos, CE, Ioannidis, JP, Toumpoulis, SK, Chamogeorgakis, T, Swistel, DG & DeRose, J 2006, 'The importance of independent risk-factors for long-term mortality prediction after cardiac surgery', European Journal of Clinical Investigation, vol. 36, no. 9, pp. 599-607. https://doi.org/10.1111/j.1365-2362.2006.01703.x
Toumpoulis IK, Anagnostopoulos CE, Ioannidis JP, Toumpoulis SK, Chamogeorgakis T, Swistel DG et al. The importance of independent risk-factors for long-term mortality prediction after cardiac surgery. European Journal of Clinical Investigation. 2006 Sep;36(9):599-607. https://doi.org/10.1111/j.1365-2362.2006.01703.x
Toumpoulis, I. K. ; Anagnostopoulos, C. E. ; Ioannidis, J. P. ; Toumpoulis, S. K. ; Chamogeorgakis, T. ; Swistel, D. G. ; DeRose, Joseph. / The importance of independent risk-factors for long-term mortality prediction after cardiac surgery. In: European Journal of Clinical Investigation. 2006 ; Vol. 36, No. 9. pp. 599-607.
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AU - Anagnostopoulos, C. E.

AU - Ioannidis, J. P.

AU - Toumpoulis, S. K.

AU - Chamogeorgakis, T.

AU - Swistel, D. G.

AU - DeRose, Joseph

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N2 - Background: The purpose of the present study was to determine independent predictors for long-term mortality after cardiac surgery. The European System for Cardiac Operative Risk Evaluation (EuroSCORE) was developed to score in-hospital mortality and recent studies have shown its ability to predict long-term mortality as well. We compared forecasts based on EuroSCORE with other models based on independent predictors. Methods: Medical records of patients with cardiac surgery who were discharged alive (n = 4852) were retrospectively reviewed. Their operative surgical risks were calculated according to EuroSCORE. Patients were randomly divided into two groups: training dataset (n = 3233) and validation dataset (n = 1619). Long-term survival data (mean follow-up 5.1 years) were obtained from the National Death Index. We compared four models: standard EuroSCORE (M1); logistic EuroSCORE (M2); M2 and other preoperative, intra-operative and post-operative selected variables (M3); and selected variables only (M4). M3 and M4 were determined with multivariable Cox regression analysis using the training dataset. Results: The estimated five-year survival rates of the quartiles in compared models in the validation dataset were: 94.5%, 87.8%, 77.1%, 64.9% for M1; 95.1%, 88.0%, 80.5%, 64.4% for M2; 93.4%, 89.4%, 80.8%, 64.1% for M3; and 95.8%, 90.9%, 81.0%, 59.9% for M4. In the four models, the odds of death in the highest-risk quartile was 8.4-, 8.5-, 9.4- and 15.6-fold higher, respectively, than the odds of death in the lowest-risk quartile (P < 0.0001 for all). Conclusions: EuroSCORE is a good predictor of long-term mortality after cardiac surgery. We developed and validated a model using selected preoperative, intra-operative and post-operative variables that has better discriminatory ability.

AB - Background: The purpose of the present study was to determine independent predictors for long-term mortality after cardiac surgery. The European System for Cardiac Operative Risk Evaluation (EuroSCORE) was developed to score in-hospital mortality and recent studies have shown its ability to predict long-term mortality as well. We compared forecasts based on EuroSCORE with other models based on independent predictors. Methods: Medical records of patients with cardiac surgery who were discharged alive (n = 4852) were retrospectively reviewed. Their operative surgical risks were calculated according to EuroSCORE. Patients were randomly divided into two groups: training dataset (n = 3233) and validation dataset (n = 1619). Long-term survival data (mean follow-up 5.1 years) were obtained from the National Death Index. We compared four models: standard EuroSCORE (M1); logistic EuroSCORE (M2); M2 and other preoperative, intra-operative and post-operative selected variables (M3); and selected variables only (M4). M3 and M4 were determined with multivariable Cox regression analysis using the training dataset. Results: The estimated five-year survival rates of the quartiles in compared models in the validation dataset were: 94.5%, 87.8%, 77.1%, 64.9% for M1; 95.1%, 88.0%, 80.5%, 64.4% for M2; 93.4%, 89.4%, 80.8%, 64.1% for M3; and 95.8%, 90.9%, 81.0%, 59.9% for M4. In the four models, the odds of death in the highest-risk quartile was 8.4-, 8.5-, 9.4- and 15.6-fold higher, respectively, than the odds of death in the lowest-risk quartile (P < 0.0001 for all). Conclusions: EuroSCORE is a good predictor of long-term mortality after cardiac surgery. We developed and validated a model using selected preoperative, intra-operative and post-operative variables that has better discriminatory ability.

KW - Cardiac surgery

KW - EuroSCORE

KW - Independent predictors

KW - Long-term mortality

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