PMID- 22329716
OWN - NLM
STAT- MEDLINE
DCOM- 20120727
LR  - 20191210
IS  - 1540-8191 (Electronic)
IS  - 0886-0440 (Linking)
VI  - 27
IP  - 2
DP  - 2012 Mar
TI  - Predictors of early and mid-term results in contemporary aortic valve replacement 
      for aortic stenosis.
PG  - 139-45
LID - 10.1111/j.1540-8191.2011.01398.x [doi]
AB  - BACKGROUND: The purpose of this study was to evaluate clinical risk factors and 
      assess the impact of the Society of Thoracic Surgeons (STS) scores on outcomes 
      after contemporary aortic valve replacement (AVR) for aortic stenosis (AS). 
      METHODS: We retrospectively analyzed the data from 209 consecutive patients with 
      AS (mean 69 +/- 9 years) who underwent AVR. The outcomes measured included 
      operative mortality, postoperative complications, postoperative prolonged length 
      of stay (PLOS), discharge to nonhome location, and mid-term mortality. RESULTS: 
      Operative mortality was 3.8%, and five-year survival was 88.6 +/- 2.8%. 
      Multivariable analysis revealed preoperative New York Heart Association (NYHA) 
      class as a significant predictor of both operative mortality (p = 0.03; odds 
      ratio [OR]: 8.5) and mid-term mortality (p = 0.02; OR: 10.5). NYHA class also 
      emerged as an independent predictor for postoperative complications (p = 0.002; 
      OR: 5.8) and PLOS (p = 0.01; OR: 2.5). Other preoperative independent predictors 
      included dialysis for PLOS (p = 0.04; OR: 2.9), age (p = 0.03; OR: 1.1), and left 
      ventricular ejection fraction (EF; p = 0.03; OR: 0.9) for nonhome discharge, and 
      EF for mid-term mortality (p = 0.01; OR: 0.9). The mean STS-PROM (predicted risk 
      of mortality) was 4.6% +/- 6.1%, and thus, the observed-to-expected (O/E) ratio of 
      operative mortality in our series was 0.82. CONCLUSIONS: Advanced NYHA class, 
      older age, dialysis, and lower EF are significant independent preoperative risk 
      factors for early and mid-term results of AVR for AS. Consideration of these 
      predictors should be used to identify high-risk patients requiring AVR for AS.
CI  - (c) 2012 Wiley Periodicals, Inc.
FAU - Kuwaki, Kenji
AU  - Kuwaki K
AD  - Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan. 
      kuwakikj@yahoo.co.jp
FAU - Amano, Atsushi
AU  - Amano A
FAU - Inaba, Hirotaka
AU  - Inaba H
FAU - Yamamoto, Taira
AU  - Yamamoto T
FAU - Matsumura, Takeshi
AU  - Matsumura T
FAU - Dohi, Shizuyuki
AU  - Dohi S
FAU - Matsushita, Satoshi
AU  - Matsushita S
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20120214
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve Stenosis/mortality/*surgery
MH  - Female
MH  - Follow-Up Studies
MH  - *Heart Valve Prosthesis Implantation/mortality
MH  - Humans
MH  - Length of Stay/statistics & numerical data
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Patient Transfer/statistics & numerical data
MH  - Postoperative Complications/epidemiology
MH  - ROC Curve
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Analysis
MH  - Treatment Outcome
EDAT- 2012/02/15 06:00
MHDA- 2012/07/28 06:00
CRDT- 2012/02/15 06:00
PHST- 2012/02/15 06:00 [entrez]
PHST- 2012/02/15 06:00 [pubmed]
PHST- 2012/07/28 06:00 [medline]
AID - 10.1111/j.1540-8191.2011.01398.x [doi]
PST - ppublish
SO  - J Card Surg. 2012 Mar;27(2):139-45. doi: 10.1111/j.1540-8191.2011.01398.x. Epub 
      2012 Feb 14.