Predicting the risk of developing postoperative complications of sternotomy for correction of valvular heart disease

• Vera V. Sokolova
• Shneider V.E.
• Stognii N.Yu.
• Arutyunyan L.A.
• Zakharov S.D.

Abstract

This article discusses the problem of predicting specific postoperative complications in cardiac surgery during the surgical treatment of valvular heart defects. The authors developed a mathematical equation based on multivariate static analysis using the logistic regression method, which allows predicting the risk of postoperative complications with high rates of accuracy and clinical significance.

A retrospective study of inpatient records of patients with heart defects who underwent prosthetics in the Cardiac Surgery Department of the Regional Clinical Hospital No. 1 of the city of Tyumen from 2014 to 2020 was carried out. All patients were divided into 2 groups without complications of sternotomy and with complications. The following access complications were identified: sternal instability requiring surgical correction, sternal osteomyelitis and sternomediastinitis.

Multivariate statistical analysis made it possible to select from among many significant factors a combination of predictors of access complications during prosthetics, which allows for prediction with 93.1% diagnostic efficiency.

According to logistic regression, the most significant initial predictors of sternotomy complications were damage to two heart valves, body mass index, severe comorbid pathology (Charlson index more than 5), especially chronic obstructive pulmonary disease and diabetes.

Implementation of the analysis results in the form of an automated information system provides support for the doctor’s decision-making, helps to objectively predict an unfavorable outcome and pre-form optimal tactical approaches to surgical treatment in these patients.

Keywords: forecasting; mathematical modeling; cardiac surgery; cardiovascular diseases; risk factors; postoperative complications

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