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The Society of Thoracic Surgeons 30-Day Predicted Risk of Mortality Score Also Predicts Long-Term Survival.
- Source :
- Annals of Thoracic Surgery; Jan2012, Vol. 93 Issue 1, p26-35, 10p
- Publication Year :
- 2012
-
Abstract
- Background: The Society of Thoracic Surgeons Predicted Risk of Mortality (PROM) score is a well-validated predictor of 30-day mortality after cardiac procedures. This study investigated the ability of PROM to predict longer-term survival. Methods: From January 1, 1996, to December 31, 2009, 24,222 patients with PROM scores underwent cardiac procedures at an academic center. Long-term all-cause mortality was determined from the Social Security Death Index. Logistic and Cox survival regression analyses evaluated the long-term predictive utility of the PROM. Area under the receiver operator characteristic curve measured the discrimination of PROM at 1, 3, 5, and 10 years. Kaplan-Meier curves were stratified by quartiles of PROM risk to compare long-term survival. All analyses were performed for the whole sample and for 30-day survivors. Results: The overall 30-day mortality was 2.78% (674 of 24,222). PROM predicted 30-day mortality extremely well (area under the receiver operator characteristic, 0.794) and predicted longer-term survival almost as well. Among all patients and 30-day survivors, area under the receiver operator characteristic values for PROM at 1, 3, 5, and 10 years were remarkably similar to the 30-day end point for which PROM is calibrated. PROM was highly predictive of Kaplan-Meier survival for patients surviving beyond 30 days. Among 30-day survivors, each percent increase in PROM score was associated with a 9.6% increase (95% confidence interval, 9.3% to 10.0%) in instantaneous hazard of death (p < 0.001). Conclusions: The PROM algorithm accurately predicts death at 30-days and during 14 years of follow-up with almost equally strong discriminatory power. This may have profound implications for informed consent and for longitudinal comparative effectiveness studies. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00034975
- Volume :
- 93
- Issue :
- 1
- Database :
- Supplemental Index
- Journal :
- Annals of Thoracic Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 69954098
- Full Text :
- https://doi.org/10.1016/j.athoracsur.2011.07.086