| Titre : | Sequential logistic models for 30 days mortality after CABG : Pre-operative, intra-operative and post-operative experience : The Israeli CABG study (ISCAB) : Three models for early mortality after CABG. (2000) |
| Auteurs : | Simchen ELISHEVA ; Mozes BENJAMIN ; Braun DALIT ; Galai NOYA ; Zitser-Gurevich YANA ; Department for Health Services Research. Ministry of Health. Jerusalem. ISR |
| Type de document : | Article |
| Dans : | European journal of epidemiology (vol. 16, n° 6, 2000) |
| Pagination : | 543-555 |
| Langues: | Anglais |
| Mots-clés : | Mortalité ; Phase postopératoire ; Epidémiologie ; Facteur risque ; Pronostic ; Homme ; Israël ; Asie ; Chirurgie ; Chirurgie cardiovasculaire ; Appareil circulatoire [pathologie] |
| Résumé : | [BDSP. Notice produite par INIST TDR0xyfO. Diffusion soumise à autorisation]. Objectives : The goal of this paper was to examine the added effect of operative and post-operative variables on 30 days mortality, in addition to patients'case-mix factors. Setting and design : A prospective study of 4835 patients, 95% of all Israeli patients who underwent coronary artery bypass grafting (CABG) in 1994. Information related to risk of death was collected at admission to hospital (preceding the operation), at time of the operation and in the immediate post-operative period. Deaths were independently ascertained. Method : Data collectors followed every patient from admission to discharge. Sequential logistic models were constructed for the case-mix'operative'and the'post-operative'periods in chronological order. Each model incorporated and adjusted for the risk estimated at the previous point in time, by forcing individual risk scores. Results : Significant pre-operative risk factors for 30 days mortality, in the case-mix model included mainly severity of illness characteristics, such as, left ventricular dysfunction and emergency admission, (c-statistic 78.8%). Model 2 (the operation'model) included in addition to the case-mix score, excessive duration of the operation per graft, bleeding, etc. (c-statistic 85.3%). The post-operative model showed the added effect of the post-operative factors such as low haemoglobin, additional surgery, and excessive time on respirator, (c-statistic 92.4%). (...) |
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