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. 2012 May 22;125(20):2423-30.
doi: 10.1161/CIRCULATIONAHA.111.055939. Epub 2012 Apr 30.

Risk score for predicting long-term mortality after coronary artery bypass graft surgery

Chuntao Wu  1 , Fabian T Camacho, Andrew S Wechsler, Stephen Lahey, Alfred T Culliford, Desmond Jordan, Jeffrey P Gold, Robert S D Higgins, Craig R Smith, Edward L Hannan
Affiliations

Risk score for predicting long-term mortality after coronary artery bypass graft surgery

Chuntao Wu et al. Circulation. .

Abstract

Background: No simplified bedside risk scores have been created to predict long-term mortality after coronary artery bypass graft surgery.

Methods and results: The New York State Cardiac Surgery Reporting System was used to identify 8597 patients who underwent isolated coronary artery bypass graft surgery in July through December 2000. The National Death Index was used to ascertain patients' vital statuses through December 31, 2007. A Cox proportional hazards model was fit to predict death after CABG surgery using preprocedural risk factors. Then, points were assigned to significant predictors of death on the basis of the values of their regression coefficients. For each possible point total, the predicted risks of death at years 1, 3, 5, and 7 were calculated. It was found that the 7-year mortality rate was 24.2 in the study population. Significant predictors of death included age, body mass index, ejection fraction, unstable hemodynamic state or shock, left main coronary artery disease, cerebrovascular disease, peripheral arterial disease, congestive heart failure, malignant ventricular arrhythmia, chronic obstructive pulmonary disease, diabetes mellitus, renal failure, and history of open heart surgery. The points assigned to these risk factors ranged from 1 to 7; possible point totals for each patient ranged from 0 to 28. The observed and predicted risks of death at years 1, 3, 5, and 7 across patient groups stratified by point totals were highly correlated.

Conclusion: The simplified risk score accurately predicted the risk of mortality after coronary artery bypass graft surgery and can be used for informed consent and as an aid in determining treatment choice.

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Conflict of interest statement

Conflict of Interest Disclosures: None

Figures

Figure 1
Figure 1
Mortality following coronary artery bypass graft surgery.
Figure 2
Figure 2
Calibration of the Cox proportional hazards model: observed (with 95% confidence interval) and predicted mortality rates for 10 groups of patients of equal size. Panel 2A, 1-year mortality. Panel 2B, 3-year mortality. Panel 2C, 5-year mortality. Panel 2D, 7-year mortality
Figure 2
Figure 2
Calibration of the Cox proportional hazards model: observed (with 95% confidence interval) and predicted mortality rates for 10 groups of patients of equal size. Panel 2A, 1-year mortality. Panel 2B, 3-year mortality. Panel 2C, 5-year mortality. Panel 2D, 7-year mortality
Figure 2
Figure 2
Calibration of the Cox proportional hazards model: observed (with 95% confidence interval) and predicted mortality rates for 10 groups of patients of equal size. Panel 2A, 1-year mortality. Panel 2B, 3-year mortality. Panel 2C, 5-year mortality. Panel 2D, 7-year mortality
Figure 2
Figure 2
Calibration of the Cox proportional hazards model: observed (with 95% confidence interval) and predicted mortality rates for 10 groups of patients of equal size. Panel 2A, 1-year mortality. Panel 2B, 3-year mortality. Panel 2C, 5-year mortality. Panel 2D, 7-year mortality
Figure 3
Figure 3
Observed (with 95% confidence interval) and predicted mortality rates by point total. Panel 3A, 1-year mortality. Panel 3B, 3-year mortality. Panel 3C, 5-year mortality. Panel 3D, 7-year mortality
Figure 3
Figure 3
Observed (with 95% confidence interval) and predicted mortality rates by point total. Panel 3A, 1-year mortality. Panel 3B, 3-year mortality. Panel 3C, 5-year mortality. Panel 3D, 7-year mortality
Figure 3
Figure 3
Observed (with 95% confidence interval) and predicted mortality rates by point total. Panel 3A, 1-year mortality. Panel 3B, 3-year mortality. Panel 3C, 5-year mortality. Panel 3D, 7-year mortality
Figure 3
Figure 3
Observed (with 95% confidence interval) and predicted mortality rates by point total. Panel 3A, 1-year mortality. Panel 3B, 3-year mortality. Panel 3C, 5-year mortality. Panel 3D, 7-year mortality
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Comment in

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