Summary of Isolated SAV-Replacement, SMV-Replacement, SMV-Repair with CABG Model based on California Inpatient Discharge Data, 2020-2021
Outcome: Mortality
Mortality includes death during the surgery admission, death during a connected subsequent acute inpatient admission, or death at an emergency department encounter or inpatient re-admission within 30 days of the index surgery Only patients are included who did not leave against medical advice after the surgery admission and who were residents of California at the time of the surgery.
Model Statistics:
Number of Observations: 3,108
% of Observations with Outcome: 6.1%
C-statistic: 0.796
Pseudo-R2: 18.4
Hosmer-Lemeshow P-Value: 0.376
Model Details:
| Risk Factor | N Cases | % Events | Estimate | Standard Error | Wald Chi2 | P-value | Odds Ratio (OR) | Lower 95% CL for OR | Upper 95% CL for OR | |
|---|---|---|---|---|---|---|---|---|---|---|
| Intercept | -2.9 | 0.4 | 68.0 | 0.000 | ||||||
| Age at Admission | 18-<50 | 79 | 8.2 | 0.2 | 0.5 | 0.2 | 0.689 | 1.2 | 0.5 | 3.3 |
| 50-<55 | 131 | 10.6 | 0.8 | 0.4 | 4.7 | 0.029 | 2.3 | 1.1 | 4.8 | |
| 55-<60 | 225 | 6.1 | 0.1 | 0.4 | 0.1 | 0.791 | 1.1 | 0.5 | 2.3 | |
| 60-<65 | 395 | 4.8 | 0.0 | 0.3 | 0.0 | 0.983 | 1.0 | 0.5 | 1.9 | |
| 65-<70 | 555 | 5.7 | Reference | |||||||
| 70-<75 | 685 | 4.7 | 0.0 | 0.3 | 0.0 | 0.990 | 1.0 | 0.6 | 1.7 | |
| 75-<80 | 600 | 7.0 | 0.4 | 0.3 | 2.0 | 0.152 | 1.5 | 0.9 | 2.5 | |
| 80 or older | 438 | 6.6 | 0.4 | 0.3 | 2.2 | 0.141 | 1.6 | 0.9 | 2.8 | |
| Patient Sex | Male | 2,385 | 5.3 | Reference | ||||||
| Female | 723 | 8.5 | 0.3 | 0.2 | 3.1 | 0.077 | 1.4 | 1.0 | 2.0 | |
| Patient Race | White | 1,905 | 5.1 | Reference | ||||||
| Non-White | 1,203 | 7.5 | 0.2 | 0.2 | 2.0 | 0.157 | 1.3 | 0.9 | 1.8 | |
| Type of Valve Procedure | SAV-Replacement Only | 1,847 | 4.3 | Reference | ||||||
| SMV-Replacement Only | 527 | 9.4 | 0.4 | 0.2 | 4.0 | 0.046 | 1.6 | 1.0 | 2.4 | |
| SMV-Repair Only | 520 | 5.8 | -0.1 | 0.3 | 0.1 | 0.723 | 0.9 | 0.6 | 1.5 | |
| Multiple Valves including SAV-Replacement, SMV-Replacement/Repair | 214 | 13.9 | 1.1 | 0.3 | 16.4 | 0.000 | 2.9 | 1.7 | 4.9 | |
| Underweight / Weight Loss | 200 | 17.6 | 0.8 | 0.2 | 10.7 | 0.001 | 2.2 | 1.4 | 3.6 | |
| Acute MI Present at Unscheduled Admission | 631 | 9.7 | 0.3 | 0.2 | 2.3 | 0.132 | 1.4 | 0.9 | 2.0 | |
| Aortic/Mitral Valve Disease/Stenosis/Insufficiency | 2,789 | 5.1 | -1.2 | 0.2 | 29.0 | 0.000 | 0.3 | 0.2 | 0.5 | |
| Atrial Fibrillation and Flutter | 968 | 6.0 | -0.2 | 0.2 | 1.5 | 0.225 | 0.8 | 0.6 | 1.2 | |
| Cardiogenic Shock | 119 | 16.3 | 0.8 | 0.3 | 7.1 | 0.008 | 2.3 | 1.2 | 4.2 | |
| Cardiomyopathy | 232 | 6.0 | -0.2 | 0.3 | 0.5 | 0.502 | 0.8 | 0.4 | 1.5 | |
| Heart Failure | 1,701 | 8.7 | 0.9 | 0.2 | 18.5 | 0.000 | 2.5 | 1.6 | 3.7 | |
| HX Sudden Cardiac Arrest (Begin 2007) | 13 | 8.5 | 0.8 | 1.1 | 0.5 | 0.486 | 2.2 | 0.2 | 20.9 | |
| Chronic Lung Disease | 319 | 8.4 | 0.4 | 0.2 | 3.3 | 0.071 | 1.5 | 1.0 | 2.5 | |
| Cerebrovascular Disease | 299 | 5.4 | -0.3 | 0.3 | 1.1 | 0.303 | 0.7 | 0.4 | 1.3 | |
| Diabetes | 1,380 | 5.6 | -0.4 | 0.2 | 5.8 | 0.016 | 0.7 | 0.5 | 0.9 | |
| Infectious Endocarditis | 109 | 9.5 | -0.2 | 0.4 | 0.2 | 0.680 | 0.8 | 0.4 | 1.9 | |
| Number of Grafts | One | 896 | 4.7 | -0.4 | 0.2 | 2.9 | 0.089 | 0.7 | 0.4 | 1.1 |
| Two | 804 | 6.9 | 0.3 | 0.2 | 1.7 | 0.196 | 1.3 | 0.9 | 1.9 | |
| Three or More | 1,408 | 6.4 | Reference | |||||||
| PCI prior to Admission | 357 | 2.5 | -1.1 | 0.4 | 7.9 | 0.005 | 0.3 | 0.2 | 0.7 | |
| Prior PCI on same Day as Surgery | 9 | 1.2 | -12.8 | 451.3 | 0.0 | 0.977 | 0.0 | 0.0 | . | |
| Pre-Op Intra-Aortic Balloon Pump | 39 | 13.4 | 0.8 | 0.6 | 1.8 | 0.176 | 2.1 | 0.7 | 6.4 | |
| Prior CABG/Valve Surgery | 147 | 4.5 | -0.2 | 0.5 | 0.1 | 0.727 | 0.9 | 0.4 | 2.1 | |
| Peripheral Vascular Disease | 555 | 5.1 | -0.2 | 0.2 | 1.0 | 0.307 | 0.8 | 0.5 | 1.2 | |
| Renal Failure | 966 | 8.4 | 0.4 | 0.2 | 4.7 | 0.030 | 1.5 | 1.0 | 2.1 | |
| Same Day Tricuspid Valve | 193 | 12.2 | 0.6 | 0.3 | 4.1 | 0.042 | 1.8 | 1.0 | 3.1 | |
| Status of Procedure Urgent | 20 | 5.0 | -0.2 | 1.1 | 0.0 | 0.887 | 0.9 | 0.1 | 7.6 | |
Notes:
If a patient had more than one surgery event of the same type on different dates during the index admission, only the surgery on the earliest date is included for fitting the model.
CL: Confidence Limit
CABG: Coronary Artery Bypass Graft
PCI: Percutaneous Coronary Intervention
SAV-Replacement: Surgical Aortic Valve Replacement
SMV-Replacement: Surgical Mitral Valve Replacement
SMV-Repair: Surgical Mitral Valve Repair