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

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 wit...

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Autores principales: de Gasperi, Ricardo, Bodanese, Luiz Carlos, Guaragna, João Carlos Vieira da Costa, Wagner, Mario Bernardes, Albuquerque, Luciano Cabral
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Cirurgia Cardiovascular 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10069247/
https://www.ncbi.nlm.nih.gov/pubmed/36592072
http://dx.doi.org/10.21470/1678-9741-2022-0254
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author de Gasperi, Ricardo
Bodanese, Luiz Carlos
Guaragna, João Carlos Vieira da Costa
Wagner, Mario Bernardes
Albuquerque, Luciano Cabral
author_facet de Gasperi, Ricardo
Bodanese, Luiz Carlos
Guaragna, João Carlos Vieira da Costa
Wagner, Mario Bernardes
Albuquerque, Luciano Cabral
author_sort de Gasperi, Ricardo
collection PubMed
description 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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spelling pubmed-100692472023-04-04 Proposed Risk Score in Patients with Aortic Stenosis Submitted to Valve Replacement Surgery de Gasperi, Ricardo Bodanese, Luiz Carlos Guaragna, João Carlos Vieira da Costa Wagner, Mario Bernardes Albuquerque, Luciano Cabral Braz J Cardiovasc Surg Original Article 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. Sociedade Brasileira de Cirurgia Cardiovascular 2023 /pmc/articles/PMC10069247/ /pubmed/36592072 http://dx.doi.org/10.21470/1678-9741-2022-0254 Text en https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
de Gasperi, Ricardo
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
title 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_short 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
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10069247/
https://www.ncbi.nlm.nih.gov/pubmed/36592072
http://dx.doi.org/10.21470/1678-9741-2022-0254
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