Initial PARSONNET  

(Predictive score for acquired adult heart surgery : Additive and Logistic Regression models)

Sex

Age

Morbid obesity

Male
Female

< 70 years
70 - 74 years
75 - 79 years
>= 80 years

Yes (>=1.5 * ideal weight)
No

Diabetes

Ejection Fraction

Hypertension

Yes (unspecified type)
No

>= 50%
30 - 49 %
< 30 %

Yes (BP > 140/90 mmHg)
or antihypertensive medications
No

Reoperation

Preoperative IABP

Left ventricular aneurysm

None
First
Second

Yes
No

Yes
No

Emergency surgery

Dialysis

Aortic valve surgery

Yes (following PTCA or catheterization complications)
No

Yes (hemodialysis or peritoneal)
No

Yes
Yes (with gradient >= 120 mmHg)
No

CABG at time of valve surgery

"Additive Model"
Univariate analysis: Predicted probability of operative mortality = SUM ((weight for risk factor) * (1 if factor present, 0 if absent))

=

Mitral valve surgery

Yes
No

Yes
Yes ( with Systolic PAP >=60 mmHg)
No

Catastrophic states

Other rare circumstances

e.g. acute structural defect,
cardiogenic shock
acute renal failure
or other conditions

(select the level of severity)

Zero
One
Two
Three
Four
Five

Paraplegia,
pacemaker dependency,
congenital heart disease in adult
severe asthma
or other conditions

(select the level of severity)

Zero
One
Two
Three
Four
Five

 

 

Multivariate Logistic Regression Model

Preoperative Risk Factors (definitions)

Values : 1 if yes, 0 otherwise ( except for age and LVEF)

Beta

p

Age

0.054

< 0.001

Aortic valve disease

NS *

Bypass only

0.038

Bypass + other procedure

0.002

Elevated cholesterol

NS

Diabetes

< 0.001

Catastrophic states

< 0.001

Familly history

NS

Female gender

< 0.001

Hypertension

0.028

Left ventricular aneurysm

NS *

Left ventricular ejection fraction

0.001

Mitral valve disease

< 0.001

Obesity

0.027 *

Preoperative IABP

< 0.001

Reoperation

< 0.001

Smoking

NS

Logit = -7.032 + sum (values * beta)
Predicted death rate within 30 days = 1 / ( 1 + e -Logit)

* factors were predicitive of increased risk of operative mortality in univariate analysis

Predicted Death Rate.

 

Ref : Parsonnet V et al. A method of uniform stratification of risk for evaluating the results of surgery in acquired adult heart disease. Circulation. 1989;79:I 3-12.

 

 

 Web page by : Jean-Yves Marandon Centre Chirurgical Marie Lannelongue (France) 

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Definitions of risk factors

One can assume the definitions are the same as in Additive Model.
For several risk factors (smoking, cholesterol...), definitions are not available.

 

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