Comparison of four risk scores for in-hospital mortality in patients undergoing heart valve surgery: A multicenter study in a Chinese population

Wang, Chong; Tang, Yangfeng; Zhang, Jiajun; Bai, Yifan; Yu, Yongchao; Zhang, Guanxin; Han, Lin

doi:10.1016/j.hrtlng.2016.06.002

Cited by 11 publications

(10 citation statements)

References 26 publications

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“…In cardiac surgery, EuroScore II showed good performance in Chinese patients receiving coronary artery bypass grafting but underpredicted mortality rates in the high-risk subgroup ( Bai et al, 2016 ). EuroScore II was suitable for predicting the operative risk in Chinese patients undergoing single valve surgery, but it could not achieve the same performance in patients receiving multiple valve surgery ( Wang et al, 2016 ). Moreover, both the STS score and the Parsonnet model had poor calibration when predicting prolonged intense care unit stay ( p value for the Hosmer–Lemeshow test <0.001) among Chinese patients receiving heart valve surgery ( Zhang et al, 2011 ).…”

Section: Discussionmentioning

confidence: 99%

External validation of five predictive models for postoperative cardiopulmonary morbidity in a Chinese population receiving lung resection

Huang

Liu

Wang

et al. 2022

PeerJ

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Background No postoperative cardiopulmonary morbidity models have been developed or validated in Chinese patients with lung resection. This study aims to externally validate five predictive models, including Eurolung models, the Brunelli model and the Age-adjusted Charlson Comorbidity Index, in a Chinese population. Methods Patients with lung cancer who underwent anatomic lung resection between 2018/09/01 and 2019/08/31 in our center were involved. Model discrimination was assessed by the area under the receiver operating characteristic curve. Model calibration was evaluated by the Hosmer–Lemeshow test. Calibration curves were plotted. Specificity, sensitivity, negative predictive value, positive predictive value and accuracy were calculated. Model updating was achieved by re-estimating the intercept and/or the slope of the linear predictor and re-estimating all coefficients. Results Among 1085 patients, 91 patients had postoperative cardiopulmonary complications defined by the European Society of Thoracic Surgeons. For original models, only parsimonious Eurolung1 had acceptable discrimination (area under the receiver operating characteristic curve = 0.688, 95% confidence interval 0.630–0.745) and calibration (p = 0.23 > 0.05) abilities simultaneously. Its sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 0.700, 0.649, 0.153, 0.960 and 0.653, respectively. In the secondary analysis, increased pleural effusion (n = 94), which was nonchylous and nonpurulent, was labeled as a kind of postoperative complication. The area under the receiver operating characteristic curve of the models increased slightly, but all models were miscalibrated. The original Eurolung1 model had the highest discrimination ability but poor calibration, and thus it was updated by three methods. After model updating, new models showed good calibration and small improvements in discrimination. The discrimination ability was still merely acceptable. Conclusions Overall, none of the models performed well on postoperative cardiopulmonary morbidity prediction in this Chinese population. The original parsimonious Eurolung1 and the updated Eurolung1 were the best-performing models on morbidity prediction, but their discrimination ability only achieved an acceptable level. A multicenter study with more relevant variables and sophisticated statistical methods is warranted to develop new models among Chinese patients in the future.

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Section: Discussionmentioning

confidence: 99%

External validation of five predictive models for postoperative cardiopulmonary morbidity in a Chinese population receiving lung resection

Huang

Liu

Wang

et al. 2022

PeerJ

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“…7,8 Unfortunately, the frequency of mitral valve surgery in Chinese patients with MR has been far lower than that which would be expected due to a number of factors, also consistent with a previous studies conducted in Western countries. [9][10][11][12] An effective transcatheter mitral valve therapy is therefore warranted to meet this unmet need, particularly in mainland China. While there are a number of different types of transcatheter mitral valve interventions being developed, the transcatheter edge-to-edge mitral valve repair technique has been recommended as a standard treatment option for patients severe symptomatic and high-surgical risk DMR or for those with FMR.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter mitral valve repair in a high‐surgical risk patient with severe degenerative mitral regurgitation using the novel DragonFly™ Transcatheter Repair device—First in man implantation in China

Liu

Lim

et al. 2021

Cathet Cardio Intervent

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Transcatheter repair of mitral regurgitation (MR) by edge-to-edge therapy has become increasingly accepted for patients with severe MR at high or prohibitive surgical risk in primary or degenerative mitral regurgitation (DMR). The technological approach has evolved from the initial transcatheter edge-to-edge device to improve on its acute reduction in MR and durability of results, particularly in complex primary pathology. In this study, we reported the first case of DragonFly™ Transcatheter Valve Repair device in a patient with severe DMR.

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“…Given the Asian patients are reluctant to undergo open-heart surgery and the observed mortality is higher than the surgical risk prediction model,24)25) there is an unmet need to ameliorate the disease awareness and the therapeutic adherence in Asians. Even though more than half of the subjects who underwent MitraClip procedure at age over 75 in western registries, Asians paid more attention about peri-operative complications and long-term efficacy especially after age of 80.…”

Section: Discussionmentioning

confidence: 99%

Can Elderly Patients with Severe Mitral Regurgitation Benefit from Trans-catheter Mitral Valve Repair?

Lee¹,

Sung²,

Huang³

et al. 2019

Korean Circ J

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Background and Objectives Age is a traditional risk factor for open-heart surgery. The efficacy and safety of transcatheter edge-to-edge mitral valve repair, using MitraClip (Abbott Vascular), has been demonstrated in patients with severe mitral regurgitation (MR). Since octogenarians or older patients are usually deferred to receive open-heart surgery, the main interest of this study is to elucidate the procedural safety and long-term clinical impact of MitraClip in elderly patients. Methods Patients with symptomatic severe MR were evaluated by the heart team. For those with high or prohibitive surgical risks, transcatheter mitral valve repair was performed in hybrid operation room. Transthoracic echocardiography (TTE), blood tests, and six-minute walk test (6MWT) were performed before, 1-month, 6-months, and 1 year after index procedure. Results A total of 46 consecutive patients receiving MitraClip procedure were enrolled. Nineteen patients (84.2±4.0 years) were over 80-year-old and 27 (73.4±11.1 years) were younger than 80. Compare to baseline, the significant reduction in MR severity was achieved after the procedure and sustained. All the patients benefited from significant improvement in New York Heart Association functional class. The 6-minute walk test (6MWT) increased from 259±114 to 319±92 meters (p=0.03) at 1 year. The overall 1-year survival rate was 80% in the elderly and 88% in those <80 years, p=0.590. Baseline 6MWT was a predictor for all-cause mortality (odds ratio, 0.99; 95% confidence interval, 0.982–0.999; p=0.026) after the MitraClip procedure. Conclusions Trans-catheter edge-to-edge mitral valve repairs are safe and have positive clinical impact in subjects with severe MR, even in advanced age.

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Comparison of four risk scores for in-hospital mortality in patients undergoing heart valve surgery: A multicenter study in a Chinese population

Cited by 11 publications

References 26 publications

External validation of five predictive models for postoperative cardiopulmonary morbidity in a Chinese population receiving lung resection

External validation of five predictive models for postoperative cardiopulmonary morbidity in a Chinese population receiving lung resection

Transcatheter mitral valve repair in a high‐surgical risk patient with severe degenerative mitral regurgitation using the novel DragonFly™ Transcatheter Repair device—First in man implantation in China

Can Elderly Patients with Severe Mitral Regurgitation Benefit from Trans-catheter Mitral Valve Repair?

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