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Gary L. Grunkemeier
Lawrence I. Bonchek
Albert Starr
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Ann Thorac Surg 1975;20:289-298
© 1975 The Society of Thoracic Surgeons

Articles

An Improved Statistical Method for Assessing the Results of Operation

Gary L. Grunkemeier, Ph.D.*, Louis E. Lambert, M.S., Lawrence I. Bonchek, M.D., Albert Starr, M.D.

From the Division of Cardiopulmonary Surgery, University of Oregon Medical School, Portland, Ore.

* Address reprint requests to Dr. Grunkemeier, 3181 S.W. Sam Jackson Park Rd., Portland, Ore. 97201

The advantages of the actuarial method of analyzing postoperative survival are now widely accepted. In evaluating the late results of heart valve replacement operations, however, certain nonfatal complications must also be considered. The use of individual event-free rates does not portray individual risk, since some valves have multiple complications. By using cumulative complication-free rates, however, it is possible to estimate the percentage of valves active and free from certain major complications for each postoperative interval. A series of actuarial curves is used, each of which represents a different major complication. These curves are subtracted progressively from the total of valves at risk, and an actuarial representation of complication-free survival results.




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