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Zürn, Christoph Manuel [Author]; Hübner, David [Author]; Ziesenitz, Victoria C. [Author]; Höhn, René Gerhard Joachim [Author]; Schuler, Lena [Author]; Schlange, Tim [Author]; Gorenflo, Matthias [Author]; Kari, Fabian Alexander [Author]; Kroll, Johannes [Author]; Loukanov, Tsvetomir [Author]; Klemm, Rolf [Author]; Stiller, Brigitte [Author]

Model-driven survival prediction after congenital heart surgery

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  • Media type: E-Article
  • Title: Model-driven survival prediction after congenital heart surgery
  • Contributor: Zürn, Christoph Manuel [Author]; Hübner, David [Author]; Ziesenitz, Victoria C. [Author]; Höhn, René Gerhard Joachim [Author]; Schuler, Lena [Author]; Schlange, Tim [Author]; Gorenflo, Matthias [Author]; Kari, Fabian Alexander [Author]; Kroll, Johannes [Author]; Loukanov, Tsvetomir [Author]; Klemm, Rolf [Author]; Stiller, Brigitte [Author]
  • Published: September 2023
  • Published in: Interdisciplinary cardiovascular and thoracic surgery ; 37(2023), 3 vom: Sept., Artikel-ID ivad089, Seite 1-7
  • Language: English
  • DOI: 10.1093/icvts/ivad089
  • Identifier:
  • Origination:
  • Footnote: Online verfügbar: 05. Juni 2023, Artikelversion: 10. September 2023
  • Description: The objective of the study was to improve postoperative risk assessment in congenital heart surgery by developing a machine-learning model based on readily available peri- and postoperative parameters.Our bicentric retrospective data analysis from January 2014 to December 2019 of established risk parameters for dismal outcome was used to train and test a model to predict postoperative survival within the first 30 days. The Freiburg training data consisted of 780 procedures; the Heidelberg test data comprised 985 procedures. STAT mortality score, age, aortic cross-clamp time and postoperative lactate values over 24 h were considered.Our model showed an area under the curve (AUC) of 94.86%, specificity of 89.48% and sensitivity of 85.00%, resulting in 3 false negatives and 99 false positives.The STAT mortality score and the aortic cross-clamp time each showed a statistically highly significant impact on postoperative mortality. Interestingly, a child’s age was barely statistically significant. Postoperative lactate values indicated an increased mortality risk if they were either constantly at a high level or low during the first 8 h postoperatively with an increase afterwards.When considering parameters available before, at the end of and 24 h after surgery, the predictive power of the complete model achieved the highest AUC. This, compared to the already high predictive power alone (AUC 88.9%) of the STAT mortality score, translates to an error reduction of 53.5%.Our model predicts postoperative survival after congenital heart surgery with great accuracy. Compared with preoperative risk assessments, our postoperative risk assessment reduces prediction error by half. Heightened awareness of high-risk patients should improve preventive measures and thus patient safety.
  • Access State: Open Access