Proposed Risk Score in Patients with Aortic Stenosis Submitted to Valve Replacement Surgery

ABSTRACT Introduction: Due to Brazilian population aging, prevalence of aortic stenosis, and limited number of scores in literature, it is essential to develop risk scores adapted to our reality and created in the specific context of this disease. Methods: This is an observational historical cohort study with analysis of 802 aortic stenosis patients who underwent valve replacement at Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, from 1996 to 2018. With the aid of logistic regression, a weighted risk score was constructed based on the magnitude of the coeficients β of the logistic equation. Two performance statistics were obtained: area under the receiver operating characteristic curve and the chi-square (χ2) of Hosmer-Lemeshow goodness-of-fit with Pearson’s correlation coeficient between the observed events and predicted as a model calibration estimate. Results: The risk predictors that composed the score were valve replacement surgery combined with coronary artery bypass grafting, prior renal failure, New York Heart Association class III/IV heart failure, age > 70 years, and ejection fraction < 50%. The receiver operating characteristic curve area was 0.77 (95% confidence interval: 0.72-0.82); regarding the model calibration estimated between observed/predicted mortality, Hosmer-Lemeshow test χ2 = 3,70 (P=0.594) and Pearson’s coeficient r = 0.98 (P<0.001). Conclusion: We propose the creation of a simple score, adapted to the Brazilian reality, with good performance and which can be validated in other institutions.

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Main Authors: Gasperi,Ricardo de, Bodanese,Luiz Carlos, Guaragna,João Carlos Vieira da Costa, Wagner,Mario Bernardes, Albuquerque,Luciano Cabral
Format: Digital revista
Language:English
Published: Sociedade Brasileira de Cirurgia Cardiovascular 2023
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382023005010207
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spelling oai:scielo:S0102-763820230050102072022-12-23Proposed Risk Score in Patients with Aortic Stenosis Submitted to Valve Replacement SurgeryGasperi,Ricardo deBodanese,Luiz CarlosGuaragna,João Carlos Vieira da CostaWagner,Mario BernardesAlbuquerque,Luciano Cabral Risk Factors Aortic Valve Stenosis Heart Valves Coronary Artery Bypass Aging ABSTRACT Introduction: Due to Brazilian population aging, prevalence of aortic stenosis, and limited number of scores in literature, it is essential to develop risk scores adapted to our reality and created in the specific context of this disease. Methods: This is an observational historical cohort study with analysis of 802 aortic stenosis patients who underwent valve replacement at Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, from 1996 to 2018. With the aid of logistic regression, a weighted risk score was constructed based on the magnitude of the coeficients β of the logistic equation. Two performance statistics were obtained: area under the receiver operating characteristic curve and the chi-square (χ2) of Hosmer-Lemeshow goodness-of-fit with Pearson’s correlation coeficient between the observed events and predicted as a model calibration estimate. Results: The risk predictors that composed the score were valve replacement surgery combined with coronary artery bypass grafting, prior renal failure, New York Heart Association class III/IV heart failure, age > 70 years, and ejection fraction < 50%. The receiver operating characteristic curve area was 0.77 (95% confidence interval: 0.72-0.82); regarding the model calibration estimated between observed/predicted mortality, Hosmer-Lemeshow test χ2 = 3,70 (P=0.594) and Pearson’s coeficient r = 0.98 (P<0.001). Conclusion: We propose the creation of a simple score, adapted to the Brazilian reality, with good performance and which can be validated in other institutions.info:eu-repo/semantics/openAccessSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery n.ahead 20232023-01-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382023005010207en10.21470/1678-9741-2022-0254
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language English
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author Gasperi,Ricardo de
Bodanese,Luiz Carlos
Guaragna,João Carlos Vieira da Costa
Wagner,Mario Bernardes
Albuquerque,Luciano Cabral
spellingShingle Gasperi,Ricardo de
Bodanese,Luiz Carlos
Guaragna,João Carlos Vieira da Costa
Wagner,Mario Bernardes
Albuquerque,Luciano Cabral
Proposed Risk Score in Patients with Aortic Stenosis Submitted to Valve Replacement Surgery
author_facet Gasperi,Ricardo de
Bodanese,Luiz Carlos
Guaragna,João Carlos Vieira da Costa
Wagner,Mario Bernardes
Albuquerque,Luciano Cabral
author_sort Gasperi,Ricardo de
title Proposed Risk Score in Patients with Aortic Stenosis Submitted to Valve Replacement Surgery
title_short Proposed Risk Score in Patients with Aortic Stenosis Submitted to Valve Replacement Surgery
title_full Proposed Risk Score in Patients with Aortic Stenosis Submitted to Valve Replacement Surgery
title_fullStr Proposed Risk Score in Patients with Aortic Stenosis Submitted to Valve Replacement Surgery
title_full_unstemmed Proposed Risk Score in Patients with Aortic Stenosis Submitted to Valve Replacement Surgery
title_sort proposed risk score in patients with aortic stenosis submitted to valve replacement surgery
description ABSTRACT Introduction: Due to Brazilian population aging, prevalence of aortic stenosis, and limited number of scores in literature, it is essential to develop risk scores adapted to our reality and created in the specific context of this disease. Methods: This is an observational historical cohort study with analysis of 802 aortic stenosis patients who underwent valve replacement at Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, from 1996 to 2018. With the aid of logistic regression, a weighted risk score was constructed based on the magnitude of the coeficients β of the logistic equation. Two performance statistics were obtained: area under the receiver operating characteristic curve and the chi-square (χ2) of Hosmer-Lemeshow goodness-of-fit with Pearson’s correlation coeficient between the observed events and predicted as a model calibration estimate. Results: The risk predictors that composed the score were valve replacement surgery combined with coronary artery bypass grafting, prior renal failure, New York Heart Association class III/IV heart failure, age > 70 years, and ejection fraction < 50%. The receiver operating characteristic curve area was 0.77 (95% confidence interval: 0.72-0.82); regarding the model calibration estimated between observed/predicted mortality, Hosmer-Lemeshow test χ2 = 3,70 (P=0.594) and Pearson’s coeficient r = 0.98 (P<0.001). Conclusion: We propose the creation of a simple score, adapted to the Brazilian reality, with good performance and which can be validated in other institutions.
publisher Sociedade Brasileira de Cirurgia Cardiovascular
publishDate 2023
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382023005010207
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