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Cited by 279Cardiac Valve Diseases and TreatmentsCardiac, Anesthesia and Surgical OutcomesAortic Disease and Treatment Approaches

Generic, Simple Risk Stratification Model for Heart Valve Surgery

Open access
Ambler, Gareth, Omar, Rumana Z., Royston, Patrick, Kinsman, Robin, Keogh, Bruce E., Taylor, Kenneth M.·2005·Circulation
DOI 10.1161/circulationaha.104.515049
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Abstract

Background— Heart valve surgery has an associated in-hospital mortality rate of 4% to 8%. This study aims to develop a simple risk model to predict the risk of in-hospital mortality for patients undergoing heart valve surgery to provide information to patients and clinicians and to facilitate institutional comparisons. Methods and Results— Data on 32 839 patients were obtained from the Society of Cardiothoracic Surgeons of Great Britain and Ireland on patients who underwent heart valve surgery between April 1995 and March 2003. Data from the first 5 years (n=16 679) were used to develop the model; its performance was evaluated on the remaining data (n=16 160). The risk model presented here is based on the combined data. The overall in-hospital mortality was 6.4%. The risk model included, in order of importance (all P <0.01), operative priority, age, renal failure, operation sequence, ejection fraction, concomitant tricuspid valve surgery, type of valve operation, concomitant CABG surgery, body mass index, preoperative arrhythmias, diabetes, gender, and hypertension. The risk model exhibited good predictive ability (Hosmer-Lemeshow test, P =0.78) and discriminated between high- and low-risk patients reasonably well (receiver-operating characteristics curve area, 0.77). Conclusions— This is the first risk model that predicts in-hospital mortality for aortic and/or mitral heart valve patients with or without concomitant CABG. Based on a large national database of heart valve patients, this model has been evaluated successfully on patients who had valve surgery during a subsequent time period. It is simple to use, includes routinely collected variables, and provides a useful tool for patient advice and institutional comparisons.

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  • Increasing age and comorbidities substantially increase both operative and long-term mortality after aortic valve replacement.

    “Increasing age and comorbidities substantially increase both operative and long-term mortality after AVR217;218.”

    From Calcific aortic stenosis (2016) · cites this paper as [217]

    The Discussion identifies age, renal failure, diabetes, hypertension, and other conditions as predictors of in-hospital mortality after aortic and/or mitral valve surgery. The Patients section defines the outcome as death before discharge; the paper does not assess long-term mortality. Its population also includes valve repair and mitral surgery, not only aortic valve replacement. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

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1 of the 28 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. [24]24. Al-Ruzzeh S, Asimakopoulos G, Ambler G, Omar R, Hasan R, Fabri B, El-Gamel A, DeSouza A, Zamvar V, Griffin S, Keenan D, Trivedi U, Pullan M, Cale A, Cowen M, Taylor K, Amrani M. Validation of four different risk stratification systems in patients undergoing off-pump coronary bypass graft surgery. Heart. 2003;89:432-435.

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Related

Authors
Ambler, G., Omar, R. Z., Royston, P., Kinsman, R., Keogh, B. E., & Taylor, K. M.
Affiliations
University College London Hospitals NHS Foundation Trust (GB)
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2005-07-12
Volume
112
Issue
2
Pages
224-231
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/circulationaha.104.515049
OpenAlex
W2113394968
Cited by
279
References
28
Citations by year
2025: 2 · 2024: 5 · 2023: 8 · 2022: 8 · 2021: 4 · 2020: 5 · 2019: 8 · 2018: 9 · 2017: 5 · 2016: 10 · 2015: 12 · 2014: 15 · 2013: 28 · 2012: 25
FWCI
15.50
Type
journal article
Language
en
Open access
Licence
public-domain
Locations
  • Circulation (publishedVersion, public-domain)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion, public-domain)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Aortic Disease and Treatment Approaches
Keywords
heart valve surgery, in-hospital mortality, risk stratification, mortality prediction model, aortic valve surgery, mitral valve surgery, concomitant coronary artery bypass grafting, risk factors, comparative institutional analysis, patient counseling
MeSH terms
Cardiac Surgical Procedures, Heart Valves, Humans, Prognosis, Risk Factors, Models, Statistical, Databases, Factual, Hospital Mortality, Risk Assessment, Knowledge Bases

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