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Updated: May 7, 2026
Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
Two novel nomograms predict 30-day mortality after off-pump coronary artery bypass grafting
Yangyan Wei1,2, Xincheng Gu2, Shengpeng Hu1
1Department of Cardiac Surgery, Wuhan Asia General Hospital, Wuhan, 430022, China.
Insights
This study developed two nomograms to predict 30-day mortality after off-pump coronary artery bypass grafting (CABG). These tools offer accurate and convenient risk assessment for patients undergoing CABG surgery.
Area of Science:
- Cardiovascular Surgery
- Medical Informatics
- Predictive Modeling
Background:
- Off-pump coronary artery bypass grafting (CABG) mortality rates are declining.
- There is a need for convenient and accurate predictive models for post-CABG mortality.
- This study addresses the lack of reliable risk assessment tools for off-pump CABG.
Purpose of the Study:
- To develop and validate two nomograms for predicting 30-day mortality after isolated off-pump CABG.
- To identify key preoperative and intraoperative factors associated with mortality.
- To provide clinicians with tools for earlier identification of high-risk patients.
Main Methods:
- A cohort of 1840 patients undergoing isolated off-pump CABG was analyzed.
- Lasso regression screened potential predictive factors, followed by multivariate logistic regression.
- Two nomograms were constructed: one including preoperative and intraoperative variables, and another using only preoperative data.
Main Results:
- The 30-day mortality rate was 3.97%.
- Key predictors included age, low BMI, surgical time, creatinine, LVEF, stroke history, and intraoperative events.
- Model 1 (preoperative & intraoperative) achieved an AUC of 0.836, significantly outperforming SinoScore.
- Model 2 (preoperative only) had an AUC of 0.745.
Conclusions:
- Two novel nomograms accurately predict 30-day mortality after isolated off-pump CABG.
- These tools offer convenient risk assessment for clinical use.
- The developed nomograms can aid in identifying high-risk patients for improved outcomes.
Background:
With the development of surgical techniques and medical equipment, the mortality rate of off-pump coronary artery bypass grafting (CABG) has been declining year by year, but there is a lack of convenient and accurate predictive models. This study aims to use two nomograms to predict 30-day mortality after off-pump CABG.
Methods:
Patients with isolated off-pump CABG from January 2016 to January 2021 were consecutively enrolled. Potential predictive factors were first screened by lasso regression, and then predictive models were constructed by multivariate logistic regression. To earlier identify high-risk patients, two nomograms were constructed for predicting mortality risk before and after surgery.
Results:
A total of 1840 patients met the inclusion and exclusion criteria. The 30-day mortality was 3.97 % (73/1840) in this cohort. Multivariate logistic analysis showed that age, BMI<18.5 kg/m2, surgical time, creatinine, LVEF, history of previous stroke, and major adverse intraoperative events (including conversion to cardiopulmonary bypass or implantation of intra-aortic balloon pump) were independently associated with 30-day mortality. Model 1 contained preoperative and intraoperative variables, and the AUC was 0.836 (p < 0.001). The AUC of the K-fold validation was 0.819. Model 2 was only constructed by preoperative information. The AUC was 0.745 (p < 0.001). The AUC of the K-fold validation was 0.729. The predictive power of Model 1 was significantly higher than the SinoScore (DeLong's test p < 0.001).
Conclusions:
The two novel nomograms could be conveniently and accurately used to predict the risk of 30-day mortality after isolated off-pump CABG.
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