Open AccessPredicting the Risk of Death from Heart Failure After Coronary Artery Bypass Graft Surgery
Author(s) -
Stephen D. Surgenor,
Gerald T. O’Connor,
Stephen J. Lahey,
Reed D. Quinn,
D. Charlesworth,
Lawrence J. Dacey,
Robert A. Clough,
Bruce J. Leavitt,
Gordon R. DeFoe,
Mary P. Fillinger,
William C. Nugent
Publication year - 2001
Publication title -
anesthesia and analgesia/anesthesia and analgesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.404
H-Index - 201
eISSN - 1526-7598
pISSN - 0003-2999
DOI - 10.1097/00000539-200103000-00008
Subject(s) - medicine , heart failure , ejection fraction , cardiology , dialysis , coronary artery bypass surgery , coronary artery disease , logistic regression , confidence interval , surgery , artery
Heart failure is the most common cause of death among coronary artery bypass graft (CABG) patients. In addition, most variation in observed mortality rates for CABG surgery is explained by fatal heart failure. The purpose of this study was to develop a clinical risk assessment tool so that clinicians can rapidly and easily assess the risk of fatal heart failure while caring for individual patients. Using prospective data for 8,641 CABG patients, we used logistic regression analysis to predict the risk of fatal heart failure. In multivariate analysis, female sex, prior CABG surgery, ejection fraction <40%, urgent or emergency surgery, advanced age (70-79 yr and >80 yr), peripheral vascular disease, diabetes, dialysis-dependent renal failure and three-vessel coronary disease were significant predictors of fatal postoperative heart failure. A clinical risk assessment tool was developed from this logistic regression model, which had good discriminating characteristics (receiver operating characteristic clinical source = 0.75, 95% confidence interval: 0.71, 0.78).