Ariyaratne et al developed a model for predicting early mortality following aortic valve replacement. This can help to identify a patient who may benefit from more aggressive management. The authors are from The Alfred Centre in Melbourne, the Geelong Hospital and Monash University in Australia.
Patient selection: aortic valve replacement surgery
Outcome: early death
Parameters:
(1) cerebrovascular disease
(2) grade of left ventricular ejection fraction LVEF)
(3) NYHA class
(4) previous cardiac surgery
(5) active infective endocarditis
(6) left main coronary artery disease
(7) renal dysfunction based on estimated GFR
(8) age in years
Parameter |
Finding |
Points |
Beta |
---|---|---|---|
cerebrovascular disease |
none |
0 |
0 |
|
coma |
3 |
0.805 |
|
CVA |
2 |
0.422 |
|
RIND/TIA |
2 |
0.417 |
LVEF |
normal |
0 |
0 |
|
mild |
1 |
0.233 |
|
moderate |
1 |
0.377 |
|
severe |
3 |
0.742 |
NYHA class |
I or II |
0 |
0 |
|
III |
2 |
0.557 |
|
IV |
4 |
1.129 |
previous cardiac surgery |
none |
0 |
0 |
|
previous CABG |
4 |
0.959 |
|
previous valve surgery |
1 |
0.256 |
|
previous other cardiac surgery |
6 |
1.425 |
active infective endocarditis |
no |
0 |
0 |
|
yes |
5 |
1.351 |
left main coronary artery disease |
no |
0 |
0 |
|
yes |
3 |
0.775 |
renal dysfunction |
none |
0 |
0 |
|
mild |
3 |
0.789 |
|
moderate |
4 |
0.990 |
|
severe |
7 |
1.873 |
|
end-stage |
7 |
1.909 |
age |
< 60 years |
0 |
0 |
|
60 to 69 years |
2 |
0.576 |
|
70 to 79 years |
4 |
1.122 |
|
>= 80 years |
6 |
1.564 |
total score =
= SUM(points for all 8 parameters)
value of X =
= SUM(beta coefficients) – 6.084
probability of early mortality =
= 1 / (1 + EXP((-1) * X))
Interpretation:
• minimum score: 0
• maximum score: 37
• The higher the score the greater the risk of early mortality.
Total Score |
Probability of Mortality |
---|---|
0 to 12 |
(0.0655 * ((score)^2)) - (0.506 * (score)) + 1.747 |
12 to 25 |
(0.2145 * ((score)^2)) - (3.59 * (score)) + 16.67 |
> 25 |
> 60% |
Specialty: Cardiology, Surgery, general
ICD-10: ,