Predicting the risk of death from heart failure after coronary artery bypass craft 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 failure and three-vessel coronary disease were significant predictors of fatal post operative heart failure. A clinical risk assessment tool was developed from this logistic regression model, which had good discriminating characterist ics (receiver operating characteristic clinical source = 0.75, 95% confiden ce interval: 0.71, 0.78).