Key result
A clinical risk assessment tool based on multiple risk factors predicted fatal postoperative heart failure in CABG patients with good discrimination (ROC 0.75; 95% CI 0.71-0.78).
Cohort (n=8,641)
Effect estimate: ROC 0.75 (95% CI 0.71-0.78)
A newly developed clinical risk assessment tool can predict the risk of fatal postoperative heart failure in CABG patients with good discrimination.
May aid preoperative risk stratification in CABG; leaves open prospective validation and outcome impact.
Heart failure is the most common cause of death among coronary artery bypass graft (CABG) patients. In addition, most variation in observed mortality rates for CABG surgery is explained by fatal heart failure. The purpose of this study was to develop a clinical risk assessment tool so that clinicians can rapidly and easily assess the risk of fatal heart failure while caring for individual patients. Using prospective data for 8,641 CABG patients, we used logistic regression analysis to predict the risk of fatal heart failure. In multivariate analysis, female sex, prior CABG surgery, ejection fraction <40%, urgent or emergency surgery, advanced age (70–79 yr and >80 yr), peripheral vascular disease, diabetes, dialysis-dependent renal failure and three-vessel coronary disease were significant predictors of fatal postoperative heart failure. A clinical risk assessment tool was developed from this logistic regression model, which had good discriminating characteristics (receiver operating characteristic clinical source = 0.75, 95% confidence interval: 0.71, 0.78).
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Surgenor et al. (2001) conducted a cohort in Coronary artery bypass graft (CABG) surgery (n=8,641). Clinical risk factors (including female sex, prior CABG, EF <40%, urgent surgery, advanced age, PVD, diabetes, dialysis, 3-vessel disease) was evaluated on Fatal postoperative heart failure (ROC 0.75, 95% CI 0.71-0.78). A clinical risk assessment tool based on multiple risk factors predicted fatal postoperative heart failure in CABG patients with good discrimination (ROC 0.75; 95% CI 0.71-0.78).
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