Guaragna et al developed a logistic regression model for evaluating a patient prior to cardiac valve surgery. This can help to identify a patient at increased risk for postoperative mortality. The authors are from Hospital Sao Lucas da Pontificia Universidade Catolica do Rio Grande do Sul in Brazil.
NOTE: The risk score developed from the same study is reported in the previous section..
Patient selection: candidate for cardiac valve replacement >= 18 years of age
Outcome: death during hospitalization
Parameters:
(1) age
(2) timing of the surgery
(3) gender
(4) left ventricular ejection fraction in percent (LVEF)
(5) concurrent coronary artery bypass graft surgery (CABG)
(6) pulmonary arterial hypertension (PAH)
(7) NYHA functional class
(8) serum creatinine in mg/dL
|
Parameter |
Finding |
Coefficient |
|
age |
< 60 years of age |
0 |
|
|
>= 60 years of age |
0.996 |
|
timing of the surgery |
elective |
0 |
|
|
urgent or emergency |
2.804 |
|
gender |
male |
0 |
|
|
female |
0.655 |
|
LVEF |
> 45% |
0 |
|
|
<= 45% |
0.761 |
|
concurrent CABG |
no |
0 |
|
|
yes |
0.938 |
|
pulmonary arterial hypertension |
no |
0 |
|
|
yes |
0.705 |
|
NYHA functional class |
I or II |
0 |
|
|
III or IV |
0.495 |
|
serum creatinine |
< 1.5 mg/dL |
0 |
|
|
1.5 to 2.49 mg/dL |
0.446 |
|
|
>= 2.5 mg/dL or dialysis |
1.793 |
X =
= SUM(points for all 8 parameters) – 4.186
probability of mortality =
= 1 / (1 + (EXP((-1) * X)
Purpose: To predict mortality in a patient undergoing valve surgery using the risk score of Guaragna et al.
Specialty: Cardiology, Surgery, general
Objective: severity, prognosis, stage
ICD-10: I97.1,
