PMID- 21315231
OWN - NLM
STAT- MEDLINE
DCOM- 20110607
LR  - 20110214
IS  - 1615-5947 (Electronic)
IS  - 0890-5096 (Linking)
VI  - 25
IP  - 2
DP  - 2011 Feb
TI  - A long-term survival score improves preoperative prediction of survival following 
      major vascular surgery.
PG  - 197-203
LID - 10.1016/j.avsg.2010.09.011 [doi]
AB  - BACKGROUND: In a previous study it has been shown that a long-term survival score 
      (LTSS), composed of Lee's Revised Cardiac Risk Index (RCRI) criteria supplemented 
      by age, preoperative electrocardiography (EKG) features, and all types of 
      diabetes to the RCRI criteria, predicts long-term (3-15 years) survival after 
      major vascular surgery. The present study aimed to investigate the performance of 
      LTSS in predicting earlier survival (3 months-3 years) as compared with the RCRI. 
      METHODS: Data from 921 consecutive patients undergoing major vascular surgery 
      (624 patients at Hadassah Medical Center [HMC] and 296 patients in Beth Israel 
      Deaconess Medical Center [BIDMC]) were collected retrospectively. The LTSS was 
      seven points that included the five RCRI factors as well as age >65 years and 
      ST-segment depression on preoperative EKG. Logistic regression and receiver 
      operating characteristic curve (ROC) curve analyses were used to compare the 3 
      months-3 years mortality between the RCRI and LTSS. RESULTS: The Beth Israel 
      Deaconess Medical Center patients were sicker than the Hadassah Medical Center 
      patients, with higher RCRI (1.2 +/- 1.0 vs. 0.81 +/- 0.83, p < 0.001) and LTSS (2.6 +/- 
      1.4 vs. 1.7 +/- 1.2, p < 0.001) and higher 3-years mortality (36.3% vs. 20.7%, p = 
      0.005). The LTSS predicted mortality better than RCRI as measured by the area 
      under the ROC curves at all time points between 6 months (0.66 +/- 0.03 vs. 0.57 +/- 
      0.04, p = 0.02) and 3 years (0.70 +/- 0.02 vs. 0.61 +/- 0.02, p < 0.0001) in both 
      institutions, but not 3-months mortality. The LTSS also provided better 
      discrimination between each adjacent two-risk score than the RCRI. CONCLUSIONS: 
      Age >65 years, ST-segment depression on preoperative 12-lead EKG, and all types 
      of diabetes added to the RCRI significantly improved the preoperative prediction 
      of mortality after 6 months following major vascular surgery.
CI  - Copyright (c) 2011 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All 
      rights reserved.
FAU - Subramaniam, Balachundhar
AU  - Subramaniam B
AD  - Department of Anesthesia, Beth Israel Deaconess, Harvard Medical School, Boston, 
      MA, USA. bsubrama@bidmc.harvard.edu
FAU - Meroz, Yuval
AU  - Meroz Y
FAU - Talmor, Daniel
AU  - Talmor D
FAU - Pomposelli, Frank B
AU  - Pomposelli FB
FAU - Berlatzky, Yaacov
AU  - Berlatzky Y
FAU - Landesberg, Giora
AU  - Landesberg G
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PL  - Netherlands
TA  - Ann Vasc Surg
JT  - Annals of vascular surgery
JID - 8703941
SB  - IM
MH  - Academic Medical Centers
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Boston
MH  - Chi-Square Distribution
MH  - Diabetes Mellitus/mortality
MH  - Electrocardiography
MH  - Female
MH  - *Health Status Indicators
MH  - Humans
MH  - Israel
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Preoperative Period
MH  - Proportional Hazards Models
MH  - ROC Curve
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Survival Analysis
MH  - Survivors/*statistics & numerical data
MH  - Time Factors
MH  - Treatment Outcome
MH  - Vascular Surgical Procedures/*mortality
EDAT- 2011/02/15 06:00
MHDA- 2011/06/08 06:00
CRDT- 2011/02/15 06:00
PHST- 2010/01/09 00:00 [received]
PHST- 2010/03/26 00:00 [revised]
PHST- 2010/09/22 00:00 [accepted]
PHST- 2011/02/15 06:00 [entrez]
PHST- 2011/02/15 06:00 [pubmed]
PHST- 2011/06/08 06:00 [medline]
AID - S0890-5096(10)00478-4 [pii]
AID - 10.1016/j.avsg.2010.09.011 [doi]
PST - ppublish
SO  - Ann Vasc Surg. 2011 Feb;25(2):197-203. doi: 10.1016/j.avsg.2010.09.011.