A Risk Prediction Model for Operative Mortality after Heart Valve Surgery in a Korean Cohort

Ho Jin Kim1, Joon Bum Kim1, Seon-Ok Kim2, Sung-Cheol Yun2, Sak Lee3, Cheong Lim4, Jae Woong Choi5, Ho Young Hwang5, Kyung Hwan Kim5, Seung Hyun Lee3, Jae Suk Yoo6, Kiick Sung7, Hyung Gon Je8, Soon Chang Hong9, Yun Jung Kim10, Sung-Hyun Kim10, and Byung-Chul Chang11

1Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea 2Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea 3Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea 4Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea 5Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea 6Department of Cardiovascular Surgery, Sejong General Hospital, Bucheon-si, Gyeonggi-do, Republic of Korea 7Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea 8Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, Republic of Korea 9Department of Thoracic and Cardiovascular Surgery, Wonju Severance Christian Hospital, Wonju-si, Gangwon-do, Republic of Korea 10National Evidence-based Healthcare Collaborating Agency (NECA), Seoul, Republic of Korea 11Department of Thoracic and Cardiovascular Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea

Purpose : This study aimed to develop a new risk prediction model for operative mortality in a Korean cohort undergoing heart valve surgery using the Korea Heart Valve Surgery Registry (KHVSR) database.

Methods : We analyzed the data of 4742 patients registered in the KHVSR undergoing heart valve surgery in 9 institutions between 2017 and 2018. A risk prediction model was developed for operative mortality defined as a death within 30 days after surgery or during the same hospitalization. A statistical model was generated with a scoring system by multiple logistic regression analyses. The model’s performance was evaluated by discrimination and calibration abilities.

Results : Operative mortality occurred in 142 patients. Final regression models identified 13 risk variables. The risk prediction model showed good discrimination with a c-statistic of 0.805 and calibration with Hosmer-Lemeshow goodness-of-fit P value of 0.630. The risk scores ranged -1 to 15, and were associated with an increase in predicted mortality. Predicted mortality across the risk scores ranged from 0.3% to 80.6%.

Conclusion : The risk prediction model dedicated to heart valve surgery was developed with a scoring system from the KHVSR database. The risk prediction model showed that the operative mortality can be predicted well in a Korean cohort.

책임저자: Byung-Chul Chang

Department of Thoracic and Cardiovascular Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea

발표자: Ho Jin Kim, E-mail : rhonin.hojin@gmail.com