Author + information
- Niv Ad,
- Sari Holmes,
- Anthony Rongione and
- Paul S. Massimiano
Background: Outcomes of cardiac surgery can be captured with accuracy within 30 days, but it is unclear whether these outcomes represent longer term outcomes. We examined whether the Society of Thoracic Surgeons (STS) risk prediction for operative mortality can accurately predict mortality beyond 30 days.
Methods: These analyses examined 7,500 patients with STS risk scores who underwent isolated coronary artery bypass graft (CABG; n=5,227), isolated valve (n=1,465), or valve/CABG (n=808) surgery. Data were collected prospectively between Jan 2005 and Sept 2015.
Results: Mean age was 64.1 yrs and mean STS risk score was 2.5%. Greater STS risk score was associated with greater risk for all-cause mortality at 1 yr (HR=1.09, P<0.001) and 5 yrs (HR=1.08, P<0.001). Multivariate Cox regression revealed multiple factors independently associated with greater risk for 5-yr mortality (TABLE). For operative deaths, STS prediction versus observed mortality was fairly accurate (2.5% vs 1.7%; O/E ratio=0.68), but for 1-yr (4%) and 5-yr (11%) mortality, observed values were well over STS risk score predictions. For example, in isolated valves, STS risk was 2.4% and 1-yr mortality was 4.7% (P<0.001).
Conclusions: The STS risk score can provide useful information on long-term survival after cardiac surgery. Although the absolute predicted value of STS score did not reflect observed mortality during follow-up, the relative STS score can help determine which patients have greater mortality risk during late follow-up.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: The Challenges of Outcome Prediction in Valvular Heart Disease
Abstract Category: 37. Valvular Heart Disease: Therapy
Presentation Number: 1274-032
- 2017 American College of Cardiology Foundation