Article Figures & Tables
Figures
- Figure 1:
(A) Calibration plot of observed versus expected rate of waitlist mortality according to decile of expected rate. (B) Observed versus expected rate of waitlist mortality by type of cardiac surgery. Error bars indicate 95% confidence intervals, obtained through 200 bootstraps. Note: CABG = coronary artery bypass grafting.
- Figure 2:
Receiver-operating characteristic curve of the CardiOttawa Waitlist Mortality Score.
Tables
- Table 1:
Baseline and operative characteristics of patients awaiting isolated CABG, valvular surgery, combined CABG and valvular surgery, or surgery on the thoracic aorta in Ontario, Oct. 1, 2008, to Sept. 30, 2019, by mortality status
Characteristic No. (%) of patients* p value Died
n = 269Did not die
n = 111 997Baseline Demographic Age, mean ± SD, yr 70.3 ± 11.0 66.4 ± 10.9 < 0.001 Age, median (IQR), yr 71 (64–79) 67 (59–74) Female sex 80 (29.7) 28 574 (25.5) 0.1 Body mass index, mean ± SD 28.1 ± 5.7 28.8 ± 5.5 Body mass index, median (IQR) 27 (24–31) 28 (25–32) 0.02 Rural residence 42 (15.6) 17 181 (15.3) 0.9 Hospital type 0.8 Community 76 (28.2) 30 932 (27.6) Teaching 193 (71.7) 81 065 (72.4) Comorbidities Hypertension 233 (86.6) 94 413 (84.3) 0.3 Atrial fibrillation 54 (20.1) 19 898 (17.8) 0.3 Recent myocardial infarction 81 (30.1) 27 295 (24.4) 0.03 CCS grading of angina pectoris (41) < 0.001 0 85 (31.6) 27 555 (24.6) 1 25 (9.3) 10 812 (9.7) 2 33 (12.3) 18 198 (16.2) 3 29 (10.8) 16 158 (14.4) 4 12 (4.5) 3865 (3.5) Low-risk acute coronary syndrome 28 (10.4) 16 632 (14.9) Intermediate-risk acute coronary syndrome 35 (13.0) 14 477 (12.9) High-risk acute coronary syndrome 22 (8.2) 4300 (3.8) Left main coronary artery or left main coronary artery equivalent disease 105 (39.0) 46 651 (41.7) 0.3 Proximal left anterior descending coronary artery disease 97 (36.1) 43 483 (38.8) 0.4 Previous percutaneous coronary intervention 28 (10.4) 12 393 (11.1) 0.7 Left ventricular ejection fraction, % < 0.001 ≥ 50 135 (50.2) 78 679 (70.3) 35–49 77 (28.6) 22 667 (20.2) 20–34 47 (17.5) 8989 (8.0) < 20 10 (3.7) 1662 (1.5) NYHA functional classification (42) < 0.001 1 147 (54.6) 75 515 (67.4) 2 57 (21.2) 17 821 (15.9) 3 51 (19.0) 15 241 (13.6) 4 14 (5.2) 3420 (3.1) Heart failure 145 (53.9) 30 217 (27.0) < 0.001 Moderate to severe mitral regurgitation 38 (14.1) 9830 (8.8) 0.002 Moderate to severe aortic regurgitation 15 (5.6) 3567 (3.2) 0.03 Severe aortic stenosis 109 (40.5) 26 192 (23.4) < 0.001 Endocarditis 0.02 None 260 (96.7) 110 207 (98.4) Acute 4–8† 1260–1264† Subacute 1–5† 526–530† Cerebrovascular disease 41 (15.2) 11 407 (10.2) 0.006 Peripheral arterial disease 61 (22.7) 15 895 (14.2) < 0.001 Smoking status 0.3 Never 121 (45.0) 52 427 (46.8) Current 60 (22.3) 21 085 (18.8) Former 88 (32.7) 38 485 (34.4) Chronic obstructive pulmonary disease 100 (37.2) 26 035 (23.2) Diabetes 135 (50.2) 47 032 (42.0) 0.007 Dyslipidemia 168 (62.5) 74 354 (66.4) 0.2 Glomerular filtration rate, mean ± SD, mL/min per 1.73 m2 69.4 ± 33.9 85.1 ± 34.8 < 0.001 Glomerular filtration rate, median (IQR), mL/min per 1.73 m2 64 (47–88) 81 (61–105) < 0.001 Dialysis 34 (12.6) 3093 (2.8) < 0.001 Anemia 37 (13.8) 9304 (8.3) 0.001 Liver disease 9 (3.3) 1551 (1.4) 0.006 Alcohol abuse 7 (2.6) 1500 (1.3) 0.07 Dementia 6 (2.2) 1475 (1.3) 0.2 Depression 7 (2.6) 1425 (1.3) 0.05 Psychosis 1–5† 212–216† < 0.001 Primary cancer 17 (6.3) 5611 (5.0) 0.3 Metastatic cancer 0 (0.0) 578 (0.5) 0.2 Operative Surgery type < 0.001 Isolated CABG 118 (43.9) 72 248 (64.5) Valvular 81 (30.1) 24 380 (21.8) CABG + valvular 63 (23.4) 11 983 (10.7) Thoracic aorta 7 (2.6) 3386 (3.0) Redo sternotomy 19 (7.1) 3315 (3.0) < 0.001 Cardiogenic shock 1–5† 218–222† 0.04 Operative priority < 0.001 Unknown 67 (24.9) 13 004 (11.6) Emergent 18 (6.7) 3460 (3.1) Urgent 90 (33.5) 31 244 (27.9) Semiurgent 41 (15.2) 25 799 (23.0) Elective 53 (19.7) 38 490 (34.4) Recommend maximum wait time, mean ± SD, d 23.3 ± 27.8 34.9 ± 31.3 < 0.001 Recommend maximum wait time, median (IQR), d 14 (3–35) 22 (13–56) Adherence to recommended wait time 124 (46.1) 74 809 (66.8) < 0.001 Variable Model β-coefficient OR (95% CI) Wald χ2 Demographic characteristics Age 0.0325 1.03 (1.02–1.05) 27.0617 Female sex 0.0384 1.04 (0.79–1.36) 0.0774 Comorbidities CCS grading of angina pectoris (41) 0 Reference Reference Reference 1 −0.0793 0.92 (0.59–1.46) 0.1159 2 −0.0537 0.95 (0.61–1.47) 0.0582 3 −0.0842 0.92 (0.58–1.46) 0.1280 4 0.3933 1.48 (0.78–2.82) 1.4389 Low-risk acute coronary syndrome −0.1812 0.83 (0.51–1.35) 0.5365 Intermediate-risk acute coronary syndrome 0.0792 1.08 (0.66–1.77) 0.1002 High-risk acute coronary syndrome 0.4167 1.52 (0.74–3.11) 1.2934 Left main coronary artery or left main coronary artery equivalent disease 0.2452 1.28 (0.98–1.76) 2.2699 Left ventricular ejection fraction, % ≥ 50 Reference Reference Reference 35–49 0.6926 2.00 (1.49–2.69) 20.9352 20–35 0.9147 2.50 (1.72–3.62) 23.2995 < 20 1.0086 2.74 (1.39–5.43) 8.3881 Heart failure 0.5546 1.74 (1.31–2.31) 14.8925 Atrial fibrillation −0.5502 0.58 (0.42–0.79) 11.6325 Dialysis 1.3167 3.73 (2.56–5.44) 47.0533 Psychosis 1.6878 5.41 (1.70–17.19) 8.1826 Operative characteristics Surgery type Isolated CABG Reference Reference Reference Valvular 0.7432 2.10 (1.33–3.32) 10.1776 CABG + valvular 0.8396 2.32 (1.58–3.40) 18.2858 Thoracic aorta 0.0213 1.02 (0.42–2.49) 0.0022 Operative priority Unknown 0.7940 2.21 (1.42–3.45) 12.2517 Emergent 0.3014 1.35 (0.60–3.04) 0.5335 Urgent −0.0096 0.99 (0.65–1.50) 0.0021 Semiurgent −0.0391 0.96 (0.62–1.49) 0.0309 Elective Reference Reference Reference Note: CABG = coronary artery bypass grafting, CCS = Canadian Cardiovascular Society, CI = confidence interval, OR = odds ratio.
In this issue
Article tools
Respond to this article
Related Articles
Cited By...
- No citing articles found.