Reliability of Modern Scores to Predict Long-Term Mortality After Isolated Aortic Valve Operations Fabio Barili, MD, PhD, Davide Pacini, MD, Mariangela.

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Reliability of Modern Scores to Predict Long-Term Mortality After Isolated Aortic Valve Operations Fabio Barili, MD, PhD, Davide Pacini, MD, Mariangela D’Ovidio, MS, Martina Ventura, MS, Francesco Alamanni, MD, Roberto Di Bartolomeo, MD, Claudio Grossi, MD, Marina Davoli, MS, Danilo Fusco, PhD, Carlo Perucci, MD, PhD, Alessandro Parolari, MD, PhD The Annals of Thoracic Surgery Volume 101, Issue 2, Pages 599-605 (February 2016) DOI: 10.1016/j.athoracsur.2015.07.088 Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Calibration plots of (Top) The Society of Thoracic Surgeons (STS) Predicted Risk of Mortality (PROM), (Middle) the updated European System for Cardiac Operative Risk Evaluation (EuroSCORE II), and (Bottom) the Age, Creatinine, Left Ventricular Ejection Fraction (ACEF) score in predicting death at 1 year. The calibration plots (dashed line, ideal; solid line, logistic calibration; dotted line, nonparametric) show a constant miscalibration in prediction, with a pattern of marked underprediction. The Annals of Thoracic Surgery 2016 101, 599-605DOI: (10.1016/j.athoracsur.2015.07.088) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Kaplan-Meier estimates with 95% confidence bands of long-term survival in patients classified within quartiles of the (Top) the updated European System for Cardiac Operative Risk Evaluation (EuroSCORE II), (Middle) The Society of Thoracic Surgeons (STS) score, and (Bottom) the Age, Creatinine, Left Ventricular Ejection Fraction (ACEF) score. A similar significant relationship between quartiles of scores and long-term survival is evident (p < 0.0001 by log-rank test for all scores). The Annals of Thoracic Surgery 2016 101, 599-605DOI: (10.1016/j.athoracsur.2015.07.088) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (A) An example is shown of the use of the regression algorithm based on the predicted perioperative The Society of Thoracic Surgeons (STS) score to estimate the long-term survival after aortic valve replacement. The algorithm derived from the semiparametric Cox model was applied to 3 different STS risks to estimate the Kaplan-Meier survival curves with 95% confidence bands. (B) The survival curves with 95% confidence bands are shown of a low-risk patient (European System for Cardiac Operative Risk Evaluation [EuroSCORE], 0.5%, black line; STS score, 0.56%, dotted line; Age, Creatinine, Left Ventricular Ejection Fraction [ACEF] mortality, 0.5%, dotted-dashed line) estimated by the three models. The Annals of Thoracic Surgery 2016 101, 599-605DOI: (10.1016/j.athoracsur.2015.07.088) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions