Is the outcome of coronary artery bypass graft surgery predictable in patients with severe ventricular function impairment?
Sixty consecutive patients, with a mean ejection fraction of 31.8% underwent coronary revascularization at the K. U. Leuven (Belgium). The operative mortality was 6%. At twelve months after surgery, the total actuarial survival was 90.0%, at twenty four months the total survival was down to 77.9%. All the preoperative data were entered into a mathematical model and using the stepwise logistic regression method, the predictability of death at 18 months postoperatively was analyzed. Using only the ejection fraction the accuracy of the prediction was 83.3%, the sensitivity 36.4% and the specificity 93.9%. Combining ejection fraction and NYHA functional classification before surgery the accuracy increased to 91.7%, the sensitivity to 72.7% and the specificity to 95.9%. Ejection fraction alone is a poor predictor of late death with only 36.4% sensitivity, but combining it with other parameters it is possible to construct a formula predicting death at 18 months with an accuracy of 91.7%.
D000206:Actuarial Analysis; D000787:Angina Pectoris / Q000401:mortality* / Q000601:surgery; D001026:Coronary Artery Bypass / Q000401:mortality*; D006801:Humans; D008875:Middle Aged; D011300:Preoperative Care; D012306:Risk; D013318:Stroke Volume