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The Annals of Thoracic Surgery, Vol 57, 12-19, Copyright © 1994 by The Society of Thoracic Surgeons
FH Edwards, RE Clark and M Schwartz
The need for accurate risk assessment has become an indispensable element
in the practice of cardiac surgery. The Society of Thoracic Surgeons
National Cardiac Surgery Database allows subscribing institutions to
perform sophisticated patient risk assessment using traditional statistical
tools and a newly developed risk model of operative mortality. The database
experience with isolated coronary artery bypass grafting has been studied
most closely at this point and serves as the basis for this report. The
approach to operative risk assessment is presented along with an analysis
of important risk factors in the practice of coronary artery surgery from
1980 through 1990. The database contains records of 80,881 patients
undergoing coronary artery bypass grafting in numerous institutions from
1980 through 1990. These records were used to conduct a detailed analysis
of risk factors associated with coronary operations in this time interval
and to present statistical methods used to formulate a risk equation that
allows one to predict the probability of operative death. In the course of
this decade, there were clearly defined trends showing a statistically
significant increase in adverse patient risk factors. The risk model has
proven to be a reliable tool for predicting the probability of operative
death in an individual patient and may be valuable in both patient
counseling and medical decision making. Large multi-institutional databases
of this type are key ingredients of modern operative risk assessment. A
database containing a broad national experience of this type can represent
an aggregate experience that may well approximate a universally accepted
standard of care.
ARTICLES
Coronary artery bypass grafting: the Society of Thoracic Surgeons National Database experience
Division of Cardiothoracic Surgery, University of Florida Health Science Center, Jacksonville 32209-6511.
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C. Blanche, S. S. Khan, A. Chaux, T. A. Denton, M. Sandhu, T.-P. Tsai, and A. Trento Cardiac reoperations in octogenarians: analysis of outcomes Ann. Thorac. Surg., January 1, 1999; 67(1): 93 - 98. [Abstract] [Full Text] [PDF]
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H.-M. Lin, H. M. Kauffman, M. A. McBride, D. B. Davies, J. D. Rosendale, C. M. Smith, E. B. Edwards, O. P. Daily, J. Kirklin, C. F. Shield, et al. Center-Specific Graft and Patient Survival Rates: 1997 United Network for Organ Sharing (UNOS) Report JAMA, October 7, 1998; 280(13): 1153 - 1160. [Abstract] [Full Text] [PDF]
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B. Mozes, L. Olmer, N. Galai, and E. Simchen A national study of postoperative mortality associated with coronary artery bypass grafting in Israel Ann. Thorac. Surg., October 1, 1998; 66(4): 1254 - 1262. [Abstract] [Full Text] [PDF]
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 M. A. Rowland, P. Nagley, A. W. Linnane, and F. L. Rosenfeldt Coenzyme Q10 treatment improves the tolerance of the senescent myocardium to pacing stress in the rat Cardiovasc Res, October 1, 1998; 40(1): 165 - 173. [Abstract] [Full Text] [PDF]
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D. F. Del Rizzo, W. D. Boyd, R. J. Novick, F. N. McKenzie, N. D. Desai, and A. H. Menkis Safety and cost-effectiveness of MIDCABG in high-risk CABG patients Ann. Thorac. Surg., September 1, 1998; 66(3): 1002 - 1007. [Abstract] [Full Text] [PDF]
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F. H. Edwards, J. S. Carey, F. L. Grover, J. W. Bero, and R. S. Hartz Impact of gender on coronary bypass operative mortality Ann. Thorac. Surg., July 1, 1998; 66(1): 125 - 131. [Abstract] [Full Text] [PDF]
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D Dougenis and A H Brown Long term results of reoperations for recurrent angina with internal mammary artery versus saphenous vein grafts Heart, July 1, 1998; 80(1): 9 - 13. [Abstract] [Full Text]
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 W. E. Boden, R. A. O'Rourke, M. H. Crawford, A. S. Blaustein, P. C. Deedwania, R. G. Zoble, L. F. Wexler, R. E. Kleiger, C. J. Pepine, D. R. Ferry, et al. Outcomes in Patients with Acute Non-Q-Wave Myocardial Infarction Randomly Assigned to an Invasive as Compared with a Conservative Management Strategy N. Engl. J. Med., June 18, 1998; 338(25): 1785 - 1792. [Abstract] [Full Text] [PDF]
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M. Carrier, L. C. Pelletier, R. Martineau, M. Pellerin, and B. C. Solymoss In elective coronary artery bypass grafting, preoperative troponin T level predicts the risk of myocardial infarction J. Thorac. Cardiovasc. Surg., June 1, 1998; 115(6): 1328 - 1334. [Abstract] [Full Text] [PDF]
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B Bridgewater, H Neve, N Moat, T Hooper, and M Jones Predicting operative risk for coronary artery surgery in the United Kingdom: a comparison of various risk prediction algorithms Heart, April 1, 1998; 79(4): 350 - 355. [Abstract] [Full Text]
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R. Malhotra, Y. Mishra, P. Maheshwari, Y. Mehta, and N. Trehan Minimally Invasive Coronary Artery Bypass as a Salvage Procedure Asian Cardiovasc Thorac Ann, March 1, 1998; 6(1): 62 - 63. [Abstract] [Full Text] [PDF]
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K. D. Murray and M. K. Pasque Routine Sternal Closure Using Six Overlapping Figure-of-8 Wires Ann. Thorac. Surg., December 1, 1997; 64(6): 1852 - 1854. [Abstract] [Full Text]
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B. W. Lytle, J. L. Navia, P. C. Taylor, F. D. Loop, W. J. E. Potts, G. Suszkowski, R. W. Stewart, P. M. McCarthy, and D. M. Cosgrove III Third Coronary Artery Bypass Operations: Risks and Costs Ann. Thorac. Surg., November 1, 1997; 64(5): 1287 - 1295. [Abstract] [Full Text]
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P. Pinna-Pintor, M. Bobbio, L. Sandrelli, M. Giammaria, F. Patane, S. Bartolozzi, G. Bergandi, and O. Alfieri Risk Stratification for Open Heart Operations: Comparison of Centers Regardless of the Influence of the Surgical Team Ann. Thorac. Surg., August 1, 1997; 64(2): 410 - 413. [Abstract] [Full Text]
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Left Coronary Ostial Stenosis: Comparison With Left Main Coronary Artery Stenosis Ann. Thorac. Surg., July 1, 1997; 64(1): 282 - 283. [Full Text]
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F. L. Grover Cardiothoracic Databases: Where Are We Headed? Ann. Thorac. Surg., June 1, 1997; 63(6): 1531 - 1532. [Full Text]
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R. P. Lippmann and D. M. Shahian Coronary Artery Bypass Risk Prediction Using Neural Networks Ann. Thorac. Surg., June 1, 1997; 63(6): 1635 - 1643. [Abstract] [Full Text]
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 M. Underwood, G. Cooper, and B. Keogh Is one arterial graft enough? BMJ, April 26, 1997; 314(7089): 1213 - 1213. [Full Text]
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 R. K. Orr Use of a Probabilistic Neural Network to Estimate the Risk of Mortality after Cardiac Surgery Med Decis Making, April 1, 1997; 17(2): 178 - 185. [Abstract] [PDF]
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R. A. Perugini, R. K. Orr, D. Porter, E. M. Dumas, and B. S. Maini Gastrointestinal Complications Following Cardiac Surgery: An Analysis of 1477 Cardiac Surgery Patients Arch Surg, April 1, 1997; 132(4): 352 - 357. [Abstract] [PDF]
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P. W. Boonstra, J. G. Grandjean, and M. A. Mariani Reoperative Coronary Bypass Grafting Without Cardiopulmonary Bypass Through a Small Thoracotomy Ann. Thorac. Surg., February 1, 1997; 63(2): 405 - 407. [Abstract] [Full Text]
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J.-L. Trouillet, A. Scheimberg, A. Vuagnat, J.-Y. Fagon, J. Chastre, and C. Gibert LONG-TERM OUTCOME AND QUALITY OF LIFE OF PATIENTS REQUIRING MULTIDISCIPLINARY INTENSIVE CARE UNIT ADMISSION AFTER CARDIAC OPERATIONS J. Thorac. Cardiovasc. Surg., October 1, 1996; 112(4): 926 - 934. [Abstract] [Full Text]
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C. D. Naylor, J. G. Jollis, and R. M. Califf Left Main Stenosis Ann. Thorac. Surg., October 1, 1996; 62(4): 1239 - 1241. [Full Text]
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