1
|
Liu Y, Xiao J, Duan X, Lu X, Gong X, Chen J, Xiong M, Yin S, Guo X, Wu Z. The multivariable prognostic models for severe complications after heart valve surgery. BMC Cardiovasc Disord 2021; 21:491. [PMID: 34635052 PMCID: PMC8504034 DOI: 10.1186/s12872-021-02268-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/11/2021] [Indexed: 11/15/2022] Open
Abstract
Background To provide multivariable prognostic models for severe complications prediction after heart valve surgery, including low cardiac output syndrome (LCOS), acute kidney injury requiring hemodialysis (AKI-rH) and multiple organ dysfunction syndrome (MODS).
Methods We developed multivariate logistic regression models to predict severe complications after heart valve surgery using 930 patients collected retrospectively from the first affiliated hospital of Sun Yat-Sen University from January 2014 to December 2015. The validation was conducted using a retrospective dataset of 713 patients from the same hospital from January 2016 to March 2017. We considered two kinds of prognostic models: the PRF models which were built by using the preoperative risk factors only, and the PIRF models which were built by using both of the preoperative and intraoperative risk factors. The least absolute shrinkage selector operator was used for developing the models. We assessed and compared the discriminative abilities for both of the PRF and PIRF models via the receiver operating characteristic (ROC) curve. Results Compared with the PRF models, the PIRF modes selected additional intraoperative factors, such as auxiliary cardiopulmonary bypass time and combined tricuspid valve replacement. Area under the ROC curves (AUCs) of PRF models for predicting LCOS, AKI-rH and MODS are 0.565 (0.466, 0.664), 0.688 (0.62, 0.757) and 0.657 (0.563, 0.751), respectively. As a comparison, the AUCs of the PIRF models for predicting LOCS, AKI-rH and MODS are 0.821 (0.747, 0.896), 0.78 (0.717, 0.843) and 0.774 (0.7, 0.847), respectively. Conclusions Adding the intraoperative factors can increase the predictive power of the prognostic models for severe complications prediction after heart valve surgery.
Collapse
Affiliation(s)
- Yunqi Liu
- Department of Cardiac Surgery, The First Affiliated Hospital of Sun Yat-Sen University, No.58, Zhongshan Road II, Guangzhou, 510080, China.,NCH Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Jiefei Xiao
- NCH Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, 510080, China.,Department of Extracorporeal Circulation, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510080, Guangdong, China
| | - Xiaoying Duan
- Department of Emergency, the Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, 518000, China
| | - Xingwei Lu
- Department of Statistical Science, School of Mathematics, Sun Yat-Sen University, Guangzhou, China.,Southern China Center for Statistical Science, Sun Yat-Sen University, Guangzhou, 510275, China
| | - Xin Gong
- Department of Statistical Science, School of Mathematics, Sun Yat-Sen University, Guangzhou, China.,Southern China Center for Statistical Science, Sun Yat-Sen University, Guangzhou, 510275, China
| | - Jiantao Chen
- Department of Cardiac Surgery, The First Affiliated Hospital of Sun Yat-Sen University, No.58, Zhongshan Road II, Guangzhou, 510080, China
| | - Mai Xiong
- Department of Cardiac Surgery, The First Affiliated Hospital of Sun Yat-Sen University, No.58, Zhongshan Road II, Guangzhou, 510080, China
| | - Shengli Yin
- Department of Cardiac Surgery, The First Affiliated Hospital of Sun Yat-Sen University, No.58, Zhongshan Road II, Guangzhou, 510080, China. .,NCH Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, 510080, China.
| | - Xiaobo Guo
- Department of Statistical Science, School of Mathematics, Sun Yat-Sen University, Guangzhou, China. .,Southern China Center for Statistical Science, Sun Yat-Sen University, Guangzhou, 510275, China.
| | - Zhongkai Wu
- Department of Cardiac Surgery, The First Affiliated Hospital of Sun Yat-Sen University, No.58, Zhongshan Road II, Guangzhou, 510080, China. .,NCH Key Laboratory of Assisted Circulation, Sun Yat-Sen University, Guangzhou, 510080, China.
| |
Collapse
|
2
|
Duchnowski P, Hryniewiecki T, Kuśmierczyk M, Szymanski P. Red cell distribution width as a predictor of multiple organ dysfunction syndrome in patients undergoing heart valve surgery. Biol Open 2018; 7:bio.036251. [PMID: 30127093 PMCID: PMC6215413 DOI: 10.1242/bio.036251] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The aim of the study was to evaluate the prognostic value of red cell distribution width (RDW) for multiple organ dysfunction syndrome (MODS) in the early postoperative period in patients undergoing valve replacement or repair surgery. A prospective study was conducted on a group of 713 patients with haemodynamically significant valvular heart disease who underwent elective valvular surgery. The primary end-point at the 30-day follow-up was postoperative MODS. The secondary end-point was death from all causes in patients with MODS. The postoperative MODS occurred in 72 patients. At multivariate analysis: RDW (OR 1.267; 95% CI 1.113-1.441; P=0.0003), creatinine (OR 1.007; 95% CI 1.001-1.013; P=0.02) and age (OR 1.047; 95% CI 1.019-1.077; P=0.001) remained independent predictors of the primary end-point. Receiver operator characteristics analysis determined a cut-off value of RDW for the prediction of the occurrence of the perioperative MODS at 14.3%. RDW (OR 1.448; 95% CI 1.057-1.984; P=0.02) and age (OR 1.057; 95% CI 1.007-1.117; P=0.04) were associated with an increased risk of death in patients with perioperative MODS. Elevated RDW is associated with a higher risk of MODS and death in patients with MODS following heart valve surgery.
Collapse
Affiliation(s)
- Piotr Duchnowski
- Institute of Cardiology, Department of Acquired Cardiac Defects, 04-628 Warsaw, Poland
| | - Tomasz Hryniewiecki
- Institute of Cardiology, Department of Acquired Cardiac Defects, 04-628 Warsaw, Poland
| | - Mariusz Kuśmierczyk
- Institute of Cardiology, Department of Cardiosurgery and Transplantology, 04-628 Warsaw, Poland
| | - Piotr Szymanski
- Institute of Cardiology, Department of Acquired Cardiac Defects, 04-628 Warsaw, Poland
| |
Collapse
|