California Cardiac Surgery Intervention Project

Summary of Isolated Valve Model based on California Inpatient Discharge Data, 2012-2013

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: 11,916
% of Observations with Outcome: 3.4%
C-statistic: 0.762Pseudo-R2: 11.9Hosmer-Lemeshow P-Value: 0.257
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 -4.5 0.2 546.6 0.000
Age at Admission18-<50 1,412 2.0 -0.8 0.3 9.1 0.003 0.4 0.3 0.8
50-<55 673 2.5 -0.4 0.3 1.9 0.170 0.7 0.4 1.2
55-<60 1,108 2.7 -0.2 0.2 0.5 0.477 0.8 0.5 1.4
60-<65 1,318 2.8 -0.2 0.2 0.5 0.479 0.8 0.5 1.3
65-<70 1,668 3.2Reference
70-<75 1,738 3.0 -0.0 0.2 0.0 0.868 1.0 0.6 1.5
75-<80 1,736 4.1 0.3 0.2 2.0 0.156 1.3 0.9 1.9
80 or older 2,263 5.2 0.6 0.2 12.1 0.000 1.9 1.3 2.7
Patient SexMale 6,711 2.8Reference
Female 5,205 4.2 0.3 0.1 9.5 0.002 1.4 1.1 1.7
RaceWhite 9,069 3.3Reference
Black 534 4.0 0.1 0.2 0.1 0.723 1.1 0.7 1.8
Other race 1,384 3.1 -0.4 0.2 5.1 0.024 0.6 0.4 0.9
Asian/Pacific Islander 929 4.4 0.3 0.2 3.4 0.064 1.4 1.0 2.0
EthnicityHispanic 2,155 4.7 0.7 0.1 19.2 0.000 1.9 1.4 2.6
Non-Hispanic 9,761 3.1Reference
Type of Valve ProcedureAV-Replacement Only 7,059 2.8Reference
MV-Replacement Only 1,621 5.8 0.7 0.1 21.4 0.000 1.9 1.5 2.6
MV-Repair Only 1,811 1.3 -0.5 0.2 5.3 0.022 0.6 0.4 0.9
Multiple Valves including AVR, MVR or MV-Repair 1,425 6.1 0.4 0.2 3.9 0.049 1.4 1.0 2.1
Acute MI Present at Scheduled Admission 33 15.4 1.8 0.5 12.0 0.001 6.0 2.2 16.6
Acute MI Present at Unscheduled Admission 194 10.5 0.6 0.3 5.3 0.021 1.9 1.1 3.2
Aortic/Mitral Valve Disease/Stenosis/Insufficiency 1,573 5.3 0.4 0.1 6.8 0.009 1.4 1.1 1.9
Atrial Fibrillation and Flutter 3,780 4.2 -0.0 0.1 0.1 0.742 1.0 0.8 1.2
Cardiogenic Shock 134 13.0 1.0 0.3 11.8 0.001 2.8 1.5 4.9
Cardiomyopathy 1,272 4.4 0.1 0.2 0.1 0.737 1.1 0.8 1.4
Heart Failure 5,085 5.1 0.6 0.1 25.5 0.000 1.8 1.4 2.3
HX Sudden Cardiac Arrest (Begin 2007) 42 2.5 -0.1 1.0 0.0 0.923 0.9 0.1 6.8
Chronic Lung Disease 1,190 4.4 0.2 0.2 1.2 0.269 1.2 0.9 1.6
Cerebrovascular Disease 771 5.2 0.2 0.2 1.7 0.190 1.3 0.9 1.8
Diabetes 3,116 3.8 -0.2 0.1 1.7 0.198 0.9 0.7 1.1
Dialysis 190 14.9 1.1 0.3 17.5 0.000 2.9 1.7 4.7
Infectious Endocarditis 716 6.6 0.7 0.2 11.7 0.001 1.9 1.3 2.8
Pre-Op Intra-Aortic Balloon Pump 178 12.0 1.2 0.3 22.5 0.000 3.4 2.1 5.7
Prior CABG/Valve Surgery 882 5.6 0.5 0.2 8.7 0.003 1.6 1.2 2.3
Peripheral Vascular Disease 1,504 3.3 -0.3 0.2 3.3 0.069 0.7 0.5 1.0
Renal Failure 2,208 6.0 0.4 0.1 9.3 0.002 1.5 1.1 1.9
Same Day Tricuspid Valve 540 8.4 0.6 0.2 6.8 0.009 1.9 1.2 3.0
Status of Procedure Urgent 62 1.8 -1.0 1.0 1.0 0.315 0.4 0.0 2.7
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

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