Predicting the risk of death from heart failure after coronary artery bypass graft surgery

Heart failure is the most common cause of death among coronary artery bypas s graft (CABG) patients. In addition, most variation in observed mortality rates for CABG surgery is explained by fatal heart failure. The purpose of this study was to develop a clinical risk assessment tool so that clinician s can rapidly and easily assess the risk of fatal heart failure while carin g for individual patients. Using prospective data for 8,641 CABG patients, we used logistic regression analysis to predict the risk of fatal heart fai lure. In multivariate analysis, female sex, prior CABG surgery, ejection fr action < 40%, urgent or emergency surgery, advanced age (70-79 yr and > 80 yr), peripheral vascular disease, diabetes, dialysis-dependent renal failur e and three-vessel coronary disease were significant predictors of fatal po stoperative heart failure. A clinical risk assessment tool was developed fr om this logistic regression model, which had good discriminating characteri stics (receiver operating characteristic clinical source = 0.75, 95% confid ence interval: 0.71, 0.78).