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. 2023 Mar 3:28:100285.
doi: 10.1016/j.ahjo.2023.100285. eCollection 2023 Apr.

Derivation and validation of predictive indices for cardiac readmission after coronary and valvular surgery - A multicenter study

Louise Y Sun  1   2 , Anna Chu  2 , Derrick Y Tam  2   3   4 , Xuesong Wang  2 , Jiming Fang  2 , Peter C Austin  2   5 , Christopher M Feindel  4   6 , Vicki Alexopoulos  7 , Natasa Tusevljak  2 , Rodolfo Rocha  2 , Maral Ouzounian  4   6 , Graham Woodward  7 , Douglas S Lee  2   4   6 ; CorHealth Ontario Cardiac Surgery Risk Adjustment Task Force
Affiliations

Derivation and validation of predictive indices for cardiac readmission after coronary and valvular surgery - A multicenter study

Louise Y Sun et al. Am Heart J Plus. .

Abstract

Objective: To derive and validate models to predict the risk of a cardiac readmission within one year after specific cardiac surgeries using information that is commonly available from hospital electronic medical records.

Methods: In this retrospective cohort study, we derived and externally validated clinical models to predict the likelihood of cardiac readmissions within one-year of isolated CABG, AVR, and combined CABG+AVR in Ontario, Canada, using multiple clinical registries and routinely collected administrative databases. For all adult patients who underwent these procedures, multiple Fine and Gray subdistribution hazard models were derived within a competing-risk framework using the cohort from April 2015 to March 2018 and validated in an independent cohort (April 2018 to March 2020).

Results: For the model that predicted post-CABG cardiac readmission, the c-statistic was 0.73 in the derivation cohort and 0.70 in the validation cohort at one-year. For the model that predicted post-AVR cardiac readmission, the c-statistic was 0.74 in the derivation and 0.73 in the validation cohort at one-year. For the model that predicted cardiac readmission following CABG+AVR, the c-statistic was 0.70 in the derivation and 0.66 in the validation cohort at one-year.

Conclusions: Prediction of one-year cardiac readmission for isolated CABG, AVR, and combined CABG+AVR can be achieved parsimoniously using multidimensional data sources. Model discrimination was better than existing models derived from single and multicenter registries.

Keywords: Aortic valve replacement; Cardiac readmission; Cardiac surgery; Coronary artery bypass grafting; Predictive modeling.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Calibration plots for observed versus expected 1-year cumulative incidence of cardiac readmission by decile of expected rate and surgery type. AVR, aortic valve replacement; CABG, coronary artery bypass; CIF, cumulative incidence function; FY, fiscal year.
See this image and copyright information in PMC

References

    1. Sun L.Y., Gaudino M., Chen R.J., Bader Eddeen A., Ruel M. Long-term outcomes in patients with severely reduced left ventricular ejection fraction undergoing percutaneous coronary intervention vs coronary artery bypass grafting. JAMA Cardiol. 2020;5(6):631–641. - PMC - PubMed
    1. Ngu J.M.C., Jabagi H., Chung A.M., et al. Defining an intraoperative hypotension threshold in association with De novo renal replacement therapy after cardiac surgery. Anesthesiology. 2020;132(6):1447–1457. - PubMed
    1. Tam D.Y., Fang J., Tran A., et al. A clinical risk scoring tool to predict readmission after cardiac surgery: an Ontario administrative and clinical population database study. Can. J. Cardiol. 2018;34(12):1655–1664. - PubMed
    1. Hannan E.L., Zhong Y., Lahey S.J., et al. 30-day readmissions after coronary artery bypass graft surgery in New York state. JACC Cardiovasc. Interv. 2011;4(5):569–576. - PubMed
    1. McNeely C., Kwedar K., Markwell S., Vassileva C.M. Improving coronary artery bypass grafting readmission outcomes from 2000 to 2012 in the medicare population. J. Thorac. Cardiovasc. Surg. 2017;154(4):1288–1297. - PubMed

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