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Supplementing prediction by EuroSCORE with social and patient reported measures among patients undergoing cardiac surgery
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  • Pernille Cromhout,
  • Lau Thygesen,
  • Philip Moons,
  • Samer Nashef,
  • Sune Damgaard,
  • Anne Christensen,
  • Trine Rasmussen,
  • Lars Thrysoee,
  • Britt Borregaard,
  • Charlotte Thorup,
  • Rikke Mols,
  • Knud Juel,
  • Selina Berg
Pernille Cromhout
Copenhagen University Hospital
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Lau Thygesen
Syddansk Universitet Statens Institut for Folkesundhed
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Philip Moons
KU Leuven
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Samer Nashef
Papworth Hospital NHS Foundation Trust
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Sune Damgaard
Copenhagen University Hospital
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Anne Christensen
Copenhagen University Hospital
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Trine Rasmussen
Gentofte University Hospital
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Lars Thrysoee
Odense Universitetshospital
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Britt Borregaard
Odense Universitetshospital
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Charlotte Thorup
Aalborg Universitetshospital
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Rikke Mols
Aarhus Universitetshospital
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Knud Juel
Syddansk Universitet Statens Institut for Folkesundhed
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Selina Berg
Syddansk Universitet Statens Institut for Folkesundhed
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Abstract

Objectives The risk of poor outcomes is traditionally attributed to biological and physiological processes in cardiac surgery. However, evidence exists that other factors, such as emotional, behavioural, social and functional, are predictive of poor outcomes. Objectives were to evaluate the predictive value of several emotional, social, functional and behavioural factors on four outcomes; death within 90 days, prolonged stay in intensive care, prolonged hospital admission and readmission within 90 days following cardiac surgery. Methods This prospective study included adults undergoing cardiac surgery 2013-2014, including information on register-based socio-economic factors and self-reported health in a nested subsample. Logistic regression analyses to determine the association and incremental value of each candidate predictor variable were conducted. Multiple regression analyses were used to determine the incremental value of each candidate predictor variable, as well as discrimination and calibration based on AUC and Brier score. Results Of 3217 patients, 3% died, 9% had prolonged intensive care stay, 51% had prolonged hospital admission and 39% were readmitted to hospital. Patients living alone (OR, 1.19; 95% CI, 1.02-1.38), with lower educational levels (1.27; 1.04-1.54) and low health-related quality of life (1.43; 1.02-2.01) had prolonged hospital admission. Analyses revealed living alone as predictive of prolonged ICU stay (Brier, 0.08; AUC, 0.68), death (0.03; 0.71) and prolonged hospital admission (0.24; 0.62). Conclusion Living alone was found to supplement EuroSCORE in predicting death, prolonged hospital admission and prolonged ICU stay following cardiac surgery. Low educational level and impaired health-related quality of life were, furthermore, predictive of prolonged hospital admission.

Peer review status:UNDER REVIEW

19 Aug 2020Submitted to Journal of Cardiac Surgery
19 Aug 2020Assigned to Editor
19 Aug 2020Submission Checks Completed
20 Aug 2020Reviewer(s) Assigned
25 Sep 2020Review(s) Completed, Editorial Evaluation Pending