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Enhancing the Value of Population-Based Risk Scores for Institutional-Level Use
Sajjad Raza, MD, Joseph F. Sabik, MD, Jeevanantham Rajeswaran, PhD, Jay J. Idrees, MD, Matteo Trezzi, MD, Haris Riaz, MD, Hoda Javadikasgari, MD, Edward R. Nowicki, MD, MS, Lars G. Svensson, MD, PhD, Eugene H. Blackstone, MD The Annals of Thoracic Surgery Volume 102, Issue 1, Pages (July 2016) DOI: /j.athoracsur Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions
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Fig 1 Observed vs predicted operative mortality and major morbidity and mortality over different predicted risk spectrum in patients undergoing isolated aortic valve replacement (AVR, blue lines) and AVR and coronary artery bypass grafting (AVR+CABG, red lines).Top smoothed curves depict density of predicted probability of operative mortality. These curves show the distribution of predicted mortality in our cohort. Symbols (isolated AVR, circles; AVR+CABG, squares) are data points obtained by averaging observed and predicted mortality over different predicted risk groups. The thin lines are locally weighted scatterplot smoothing (LOWESS) nonparametric smoothed lines obtained by using the symbols. (A) Operative mortality. (B) Major morbidity and mortality. The Annals of Thoracic Surgery , 70-77DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions
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Fig 2 Standardized differences by which Cleveland Clinic coefficients deviate from The Society of Thoracic Surgeons (STS) coefficients, demonstrating institution-specific lower, similar, and higher risk variables using the STS operative mortality and major morbidity and mortality models. (A) Operative mortality after isolated aortic valve replacement (AVR). (B) Operative mortality after AVR and coronary artery bypass grafting (AVR+CABG). (C) Major morbidity and mortality after isolated AVR. (D) Major morbidity and mortality after AVR+CABG. (Afib = atrial fibrillation; BSA = body surface area; CHF = congestive heart failure; CV = cardiovascular; CVA = cerebrovascular accident; CVD = cerebrovascular disease; EF = ejection fraction; endo = endocarditis; IABP = intraaortic balloon pump; LMT = left main trunk; MI = myocardial infarction; MV = mitral valve; NYHA = New York Heart Association; PVD = peripheral vascular disease; TV = tricuspid valve.) The Annals of Thoracic Surgery , 70-77DOI: ( /j.athoracsur ) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions
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