期刊论文详细信息
Journal of Clinical Medicine
One and Five-Year Mortality Risk Prediction in Patients with Moderate and Severe Aortic Stenosis
Roland Assi1  Rita K. Milewski1  Markus Krane1  Chirag Ram1  Sameh Yousef1  Andrea Amabile1  Arnar Geirsson1  Prashanth Vallabhajosyula1  Saket Singh1  Ritu Agarwal2  Yawie Zhang3  Huang Huang3 
[1] Division of Cardiac Surgery, Yale School of Medicine, New Haven, CT 06510, USA;Joint Data Analytics Team, Information Technology Service, Yale University, New Haven, CT 06520, USA;Section of Surgical Outcomes and Epidemiology, Yale School of Public Health, New Haven, CT 06510, USA;
关键词: aortic;    stenosis;    mortality;    risk;    prediction;   
DOI  :  10.3390/jcm11102949
来源: DOAJ
【 摘 要 】

(1) Background: Our goal was to develop a risk prediction model for mortality in patients with moderate and severe aortic stenosis (AS). (2) Methods: All patients aged 40–95 years, with echocardiographic evidence of moderate and severe AS at a single institution, were studied over a median of 2.8 (1.5–4.8) years, between 2013–2018. Patient characteristics and mortality were compared using Chi-squares, t-tests, and Kaplan–Meier (KM) curves, as appropriate. The risk calculation for mortality was derived using the Cox proportional hazards model. A risk score was calculated for each parameter, and the total sum of scores predicted the individualized risks of 1-and 5-year mortality. (3) Results: A total of 1991 patients with severe and 2212 with moderate AS were included. Severe AS patients were older, had a lower ejection fraction %, were more likely to be Caucasian, and had lower rates of obesity and smoking, but had higher rates of cardiac comorbidities and AVR (49.3% vs. 2.8%, p < 0.0001). The unadjusted overall mortality was 41.7% vs. 41%, p = 0.6530, and was not different using KM curves (log rank, p = 0.0853). The models included only patients with complete follow-up (3966 in the 1-year, and 816 in the 5-year model) and included 13 variables related to patient characteristics, degree of AS, and AVR. The C-statistic was 0.75 and 0.72 for the 1-year and the 5-year models, respectively. (4) Conclusions: Patients with moderate and severe AS experience high morbidity and mortality. The usage of a risk prediction model may provide guidance for clinical decision making in complex patients.

【 授权许可】

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