Author + information
- Venkatesan Dyanesh Vidi,
- Javier Reyna,
- Orlando Santana,
- Helen Parise,
- Joseph Lamelas and
- Gervasio A. Lamas
The STS risk prediction score is applicable only for patients undergoing midline sternotomy. Hence, we sought to develop a simple risk score for prediction of Society of Thoracic Surgeons (STS) composite endpoint for patients undergoing minimally invasive valve surgery (MIVS).
A total of 960 patients who underwent MIVS were randomly assigned to a development and validation dataset (480 patients each). Multivariable logistic regression was then used to identify independent predictors with a p–value of <0.1. Based on the odds ratios, five identified variables (age>55 years, GFR<60 cc/min, history of cerebrovascular accident, heart failure in the preceding two weeks, left ventricular ejection fraction <55%) were assigned a weighted integer; the sum of the integers was a total risk score for each patient.
The rate of composite endpoint in the development cohort was 21% (14.3% for low [≤7], 19.5% for intermediate [8–13], and 54% for high [≥14] risk score). The rate of composite endpoint increased exponentially with the increasing risk score (Cochrane Armitage chi–square, p<0.0001). In the 480 patients of the validation dataset, the model demonstrated a good discriminatory power (c–statistic = 0.71); the increasing risk score was strongly associated with the occurrence of composite endpoint (see table).
The risk of STS composite endpoint for patients undergoing MIVS can be easily assessed by readily available baseline clinical characteristics of patients.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.–10:30 a.m.
Session Title: Cardiac Surgical Outcomes and Quality of Care
Abstract Category: 28. Quality of Care and Outcomes Assessment
Presentation Number: 1289–111
- 2013 American College of Cardiology Foundation