The National Evidence-based Healthcare Collaborating Agency (NECA) said it has developed a way to predict the post-surgical risk of early death before conducting heart valve surgery, jointly with the Korean Society for Thoracic and Cardiovascular Surgery.
Researchers at the two institutions analyzed 4,766 patients who received cardiac valve surgery at nine tertiary hospitals from January 2017 to December 2018 and found 13 major predictive factors of early mortality.
|A domestic research team has developed a model that can foretell the risk of early postoperative death after heart valve surgery. (NECA)|
The method of predicting early death is a schematic model made of predictive factors that affect mortality within 30 days after surgery.
By putting the patient's condition into the model, the risk of death after surgery can be confirmed, making it possible to establish a customized treatment for the patient in advance.
The main predictors of early mortality include age, heart failure severity called the NYHA Class, the urgency of operation, chronic diseases such as diabetes and cerebrovascular disease, history of heart surgery, and whether coronary artery bypass surgery was accompanied.
The risk index is divided into 17 stages ranging from minus 1 to 15, depending on the predictors. Notably, the risk index increased by two steps when the operation was urgent, kidney function dropped, or patients were over 80.
The early mortality rate was 0.3 percent at the lowest risk level and reached 80.6 percent in the highest case. The risk of early postoperative death increased with the index’s rise.
Until now, the domestic medical community has mainly used methods developed in the U.S. and Europe. However, it was difficult to apply the Western ways to Korean patients, the agency said.
"Our model allows for customized therapy in clinical settings and provides a basis for explaining the risk of surgery and obtaining consent from patients," said Professor Kim Joon-bum of Asan Medical Center, who led the joint study.
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